CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Uh Regional Hospitals

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,612
  • Cash Discount Price: $2,370
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Uh Regional Hospitals is $1,612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,370. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.74x the Medicare baseline. Located in 13207 Ravenna Road, Chardon, OH.
Cash / Self-Pay
$2,370

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,612

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: $2,370 (256%)
Insurance Median: $1,612 (174%)
Cash: $2,370 (256% of Medicare)
Ins. Median: $1,612 (174% 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
Medical Mutual Of Ohio $815 - $2,212 88%
Aetna $869 - $3,602 94%
Blue Cross Blue Shield $869 - $3,264 94%
Cigna $869 - $2,538 94%
Devoted Health $869 94%
Humana $869 94%
Molina $869 94%
Primetime Health Plan $869 94%
Summacare $869 - $1,612 94%
The Health Plan $869 - $2,086 94%
UnitedHealthcare $869 - $2,013 94%
Wellcare By Allwell $869 94%
Paramount $895 97%
Perennial Advantage Of Ohio $913 99%
Valor Health Plans $913 99%
Amish Aid Community Plan $1,454 157%
Amish Church Fund And Workers Aid Plan $1,454 157%
Buckeye Plain Ministries $1,454 157%
Clarity $1,517 164%
Jp Farley $1,517 164%
Ambetter / Centene $1,564 169%
Caresource $1,564 169%
Christian Healthcare Ministries $1,580 171%
Immergrun $1,580 171%
Sunrise Plan Communities $1,580 171%
Aultcare $1,738 188%
University Health Employee Plan (Contigo) $1,857 200%
Healthsmart $2,054 222%
Ohio Health Choice $2,054 - $2,844 222%
Beech Street $2,528 - $2,844 273%
Ohio Preferred Network $2,528 - $2,844 273%
First Health $2,623 283%
Century Health Network $2,686 290%
Private Healthcare System $2,718 293%
Configurenet $2,844 307%
Fortified Provider Network $2,844 307%
Multiplan $2,844 307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13207 Ravenna Road, Chardon, OH 44024
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals