CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Mercy Regional Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$954
about 1.0× the $927 Medicare rate · typically $493–$1,446
modeled estimate · not a bill or quote
What this hospital charges insurers
$858
Below the fair price — a good deal
about $96 under the fair price · 0.9× Medicare
Medicare pays $927 Fair price $954 This hospital $858 Cash price $6,493 Hospital's list price $10,821

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 $858

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $954 (about 1.0× the $927 Medicare rate). Mercy Regional Medical Center charges insurers about $858, or about $6,493 in cash — below the fair price — a good deal. Located in Lorain, OH.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna✓ Humana Blue Cross Blue ShieldCignaKaiser 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 $858 93%
Aetnamajor $858 93%
Humanamajor $858 93%
CareSource $875 94%

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 3700 Kolbe Road, Lorain, OH 44053
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals