CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Fisher-Titus Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $326
  • Cash Discount Price: $558
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Fisher-Titus Hospital is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.35x the Medicare baseline. Located in 272 Benedict Avenue, Norwalk, OH.
Cash / Self-Pay
$558

Average discount available for prompt cash payment at this facility.

Insurance Median
$326

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: $558 (60%)
Insurance Median: $326 (35%)
Cash: $558 (60% of Medicare)
Ins. Median: $326 (35% 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
Aetna $109 - $879 12%
Martin'S Point $110 - $129 12%
Humana $116 - $140 13%
Blue Cross Blue Shield $129 - $5,398 14%
Buckeye $129 - $879 14%
Caresource $129 - $879 14%
Devoted $129 14%
Medical Mutual Of Ohio $129 - $879 14%
Medigold $129 14%
Meridan $129 14%
Paramount $129 - $879 14%
Perennial Advantage $129 - $923 14%
Summacare $129 - $879 14%
UnitedHealthcare $129 - $897 14%
Zinghealth $131 14%
Sidecar $133 - $1,739 14%
Valor Health $133 - $906 14%
Gateway $135 15%
Perennial $135 15%
Wellcare $135 - $879 15%
Health Scope $155 17%
Emerald Health $161 - $853 17%
Frontpath $167 18%
Ohio Health Choice $167 - $791 18%
Cigna $180 - $703 19%
Clarity Health $180 19%
Multiplan $180 - $791 19%
Coresource $183 20%
First Health $183 - $791 20%
Health Ohio Network $193 - $615 21%
Tricare $272 - $703 29%
Claimsdoc $290 - $703 31%
Healthscope $329 - $800 36%
Amerihealth $495 53%
Molina $495 53%
Zing Health $879 95%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 272 Benedict Avenue, Norwalk, OH 44857
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals