CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Lima Memorial Health System
Billing Code: 43239 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$1,038
about 1.1× the $927 Medicare rate · typically $967–$1,531
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $1,038 Cash price $1,016 Hospital's list price $1,129
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
2 of 6 major insurers have a published price at this hospital
✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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 | $3,584 - $3,982 | 387% |
| Aetnamajor | $866 - $1,039 | 93% |
| CareSource | $1,516 | 164% |
| Devoted Health | $875 | 94% |
| + 1 smaller / regional plan | $1,472 |
Self-Pay How to get the cash price
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Other Procedures at Lima Memorial Health System
Compare: Upper endoscopy with biopsy at other OH hospitals
- Cincinnati Children's Hospital Medical Center · Cincinnati $175
- Fisher-Titus Hospital · Norwalk $180
- Southern Ohio Medical Center · Portsmouth $181
- Union Hospital · Dover $201
- Southwest General Health Center · Middleburg Heights $228
- Henry County Hospital, Inc · Napoleon $322
- Akron Children's Hospital · Akron $337
- Highland District Hospital · Hillsboro $495
Insurance negotiated median for the same procedure, sorted lowest first.