CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Guthrie Cortland Regional Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$973

about 1.0× the $927 Medicare rate · typically $730–$1,455

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,030

About the fair price

about $57 over the fair price · 1.1× Medicare

Medicare pays $927 Fair price $973 This hospital $1,030 Cash price $4,969 Hospital's list price $6,211

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $110 Priciest $1,030

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $973 (about 1.0× the $927 Medicare rate). Guthrie Cortland Regional Medical Center charges insurers about $1,030, or about $4,969 in cash — about the fair price. Located in Cortland, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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
UnitedHealthcaremajor	$880 - $5,155	95%
Blue Cross Blue Shieldmajor	$366 - $6,211	39%
Aetnamajor	$987 - $1,109	107%
Humanamajor	$871 - $1,109	94%
AmeriHealth	$193 - $1,224	21%
CDPHP	$948 - $6,211	102%
Fidelis Care	$823 - $6,211	89%
Geisinger	$195 - $1,109	21%
HealthPartners	$728 - $1,030	79%
MVP Health Care	$1,061 - $6,211	115%
UPMC Health Plan	$1,109	120%
WellCare	$886 - $6,211	96%
+ 3 smaller / regional plans	$948 - $6,211

Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,969), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Guthrie Cortland Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Guthrie Cortland Regional Medical Center

Compare: Upper endoscopy with biopsy at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.