CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 43239 (CPT)

No verified fair price for this procedure here

This hospital only published government or network rates for this billing code — not a standard commercial price — so we can’t show a verified fair-price comparison for it. What it charges each insurer is listed below; call the hospital’s billing office to confirm the actual charge.

modeled estimate · not a bill or quote

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	$613 - $2,005	66%
Blue Cross Blue Shieldmajor	$809 - $2,088	87%
Aetnamajor	$586 - $5,388	63%
Cignamajor	$1,597 - $1,653	172%
Humanamajor	$492 - $5,521	53%
AmeriHealth	$820 - $1,187	88%
CareSource	$727 - $1,087	78%
Molina	$727 - $5,388	78%
+ 10 smaller / regional plans	$482 - $5,413

Government programs also on file: Medicare, Medicaid.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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, 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 Arthur G James Cancer Hospital and Research Institute 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.

Other Procedures at Arthur G James Cancer Hospital and Research Institute

Compare: Upper endoscopy with biopsy at other OH hospitals

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