CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Trinity Medical Ctr East &Trinity Medical Ctr West

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$913

about 1.0× the $927 Medicare rate · typically $866–$1,469

modeled estimate · not a bill or quote

What this hospital charges insurers

$866

About the fair price

about $47 under the fair price · 0.9× Medicare

Medicare pays $927 Fair price $913 This hospital $866 Cash price $511 Hospital's list price $1,030

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 $866

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 $913 (about 1.0× the $927 Medicare rate). Trinity Medical Ctr East &Trinity Medical Ctr West charges insurers about $866, or about $511 in cash — about the fair price. Located in Steubenville, 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	$772 - $866	83%
Blue Cross Blue Shieldmajor	$866 - $3,496	93%
Aetnamajor	$866	93%
Cignamajor	$690	74%
Humanamajor	$745 - $793	80%
Ambetter (Centene)	$866	93%
CareSource	$910 - $1,450	98%
Medical Mutual	$866	93%
Molina	$866	93%
+ 2 smaller / regional plans	$193 - $745

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 511), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Trinity Medical Ctr East &Trinity Medical Ctr West is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Trinity Medical Ctr East &Trinity Medical Ctr West

Compare: Upper endoscopy with biopsy at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.