CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: South Pointe Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$887
about 1.0× the $927 Medicare rate · typically $524–$1,223
modeled estimate · not a bill or quote
What this hospital charges insurers
$869
About the fair price
about $18 under the fair price · 0.9× Medicare
Medicare pays $927 Fair price $887 This hospital $869 Cash price $2,426 Hospital's list price $3,732

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $175 Priciest $869

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

A fair price for a Upper endoscopy with biopsy is about $887 (about 1.0× the $927 Medicare rate). South Pointe Hospital charges insurers about $869, or about $2,426 in cash — about the fair price. Located in Warrensville Heights, OH.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $703 - $4,338 76%
Blue Cross Blue Shieldmajor $777 - $2,924 84%
Aetnamajor $869 - $3,732 94%
Cignamajor $895 - $2,986 97%
Humanamajor $869 - $3,172 94%
AmeriHealth $814 88%
CareSource $792 85%
Devoted Health $869 94%
Molina $777 84%
Oscar Health $1,124 - $1,435 121%
Paramount $763 82%
UniCare $913 99%
UPMC Health Plan $869 - $2,239 94%
+ 16 smaller / regional plans $777 - $3,359
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 20000 Harvard Road, Warrensville Heights, OH 44122
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals