CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: UPMC Chautauqua at Wca

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,197

about 1.3× the $927 Medicare rate · typically $634–$1,219

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,146

About the fair price

about $51 under the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,197 This hospital $1,146 Cash price $1,153 Hospital's list price $1,921

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 $1,146

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

A fair price for a Upper endoscopy with biopsy is about $1,197 (about 1.3× the $927 Medicare rate). UPMC Chautauqua at Wca charges insurers about $1,146, or about $1,153 in cash — about the fair price. Located in Jamestown, 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	$1,146 - $1,249	124%
Blue Cross Blue Shieldmajor	$1,034 - $1,987	112%
Aetnamajor	$1,191 - $1,249	129%
Humanamajor	$1,146 - $1,537	124%
Fidelis Care	$1,146	124%
Geisinger	$207	22%
HealthPartners	$224	24%
Independent Health	$1,085 - $1,412	117%
MagnaCare	$555 - $1,441	60%
UPMC Health Plan	$186 - $1,168	20%
WellCare	$1,180	127%
+ 3 smaller / regional plans	$115 - $1,537

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 1,153), 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 UPMC Chautauqua at Wca 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 UPMC Chautauqua at Wca

Compare: Upper endoscopy with biopsy at other NY hospitals

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