CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Adirondack Medical Center - Saranac Lake
Billing Code: 43239 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$964
about 1.0× the $927 Medicare rate · typically $453–$1,647
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $964 Cash price $482 Hospital's list price $777
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
3 of 6 major insurers have a published price at this hospital
✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| Blue Cross Blue Shieldmajor | $420 - $3,091 | 45% |
| Aetnamajor | $1,188 | 128% |
| Cignamajor | $622 | 67% |
| CDPHP | $1,188 | 128% |
| MVP Health Care | $622 | 67% |
| WellCare | $1,212 | 131% |
| + 1 smaller / regional plan | $1,188 |
Government programs also on file: Medicare, Military & VA.
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Other Procedures at Adirondack Medical Center - Saranac Lake
Compare: Upper endoscopy with biopsy at other NY hospitals
- Maimonides Medical Center · Brooklyn $110
- Geneva General Hospital · Geneva $141
- Kenmore Mercy Hospital · Kenmore $160
- Sisters of Charity Hospital · Buffalo $204
- Elizabethtown Community Hospital · Elizabethtown $232
- The University of Vermont Health Network-Alice Hy · Malone $253
- Mercy Hospital of Buffalo · Buffalo $313
- Saratoga Hospital · Saratoga Springs $319
Insurance negotiated median for the same procedure, sorted lowest first.