CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Bertrand Chaffee Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $235
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Bertrand Chaffee Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.25x the Medicare baseline. Located in 224 East Main Street, Springville, NY.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $193 (21%)
Insurance Median: $235 (25%)
Cash: $193 (21% of Medicare)
Ins. Median: $235 (25% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $128 - $352 14%
Tricare $128 - $352 14%
Iha Encompass 65 $129 14%
Private Pay $186 - $199 20%
Blue Cross Blue Shield $192 - $1,949 21%
Aetna $219 - $352 24%
American Progressive Ins. $219 - $234 24%
Cigna $219 - $352 24%
Commercial / Misc $219 - $234 24%
Global Excel Mgt $219 - $234 24%
Guardian Life Ins. Co. $219 - $234 24%
Mvp Commercial $219 - $234 24%
No Amer Meritian Health $219 - $234 24%
No-Fault $219 - $234 24%
Nova Healthcare $219 - $234 24%
Advantra-Mcr Advantage $352 38%
Centers Plan Hlty Living $352 38%
Champva $352 38%
Ctrs Plan For Hlthy Livng $352 38%
Geisinger Health Plan $352 38%
Humana $352 38%
Lifetime Benefits $352 38%
Mutual Of Omaha $352 38%
Optimum Healthcare - Mcr $352 38%
Todays Option - Amer Prog $352 38%
United Hc Mcr Solutions $352 38%
UnitedHealthcare $352 38%
Wellcare $352 38%
Univera Healthcare $864 93%
Univera Senior Choice $864 93%
Senior Blue - Bc $1,409 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 224 East Main Street, Springville, NY 14141
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals