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CMS Price Transparency Data Hospital file updated: 2026-07-14

Upper endoscopy with biopsy

Facility: Lake Health Beachwood Medical Center

Billing Code: 43239 (CPT)

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
$904Fair BaseRate (1.00× Market)
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

This hospital's typical commercial price is $900 compared to the $904 fair price benchmark.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

The BaseRate · fair price high confidence
A fair price for this
$904
about 1.0× the $927 Medicare rate · typically $488–$1,157
modeled estimate · not a bill or quote
What this hospital charges insurers
$900
About the fair price
about $4 under the fair price · 1.0× Medicare
Medicare pays $927 Fair price $904 This hospital $900 Cash price $2,465 Hospital's list price $3,286

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 $140 Priciest $900

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 $904 (about 1.0× the $927 Medicare rate). Lake Health Beachwood Medical Center charges insurers about $900, or about $2,465 in cash — about the fair price. Located in Beachwood, 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

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumana 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 $858 - $2,169 93%
Blue Cross Blue Shieldmajor $858 - $1,673 93%
Aetnamajor $858 - $2,992 93%
Cignamajor $858 - $1,966 93%
Humanamajor $858 93%
Ambetter (Centene) $1,545 167%
CareSource $1,545 167%
Devoted Health $858 93%
Health Net $2,793 301%
Medical Mutual $858 - $2,173 93%
Molina $858 93%
Paramount $884 95%
WellCare $858 93%
+ 17 smaller / regional plans $858 - $2,957
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 25501 Chagrin Boulevard, Beachwood, OH 44122
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals

Other Procedures at Lake Health Beachwood Medical Center

Compare: Upper endoscopy with biopsy at other OH hospitals

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

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at Lake Health Beachwood Medical Center (Zero PHI Required)

CMS CCN: 360367
CPT 43239
Fair BaseRate™ $904
Medicare Rate $927
Self-Pay Cash $2,465
Insurer Median $900
Pre-filled with Lake Health Beachwood Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $1,193 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,193

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,193).

Step 2 · Cash vs. Insurance Arbitrage Save $821 Paying Cash

Self-Pay Cash Rate ($2,465) Beats Your Bill

Lake Health Beachwood Medical Center's published 45 CFR § 180 self-pay cash rate is $2,465 (vs. $900 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,382 Above Fair BaseRate

Negotiate Toward $904 Fair BaseRate ($927 Medicare)

Your bill ($3,286) is $2,382 above the denoised Fair BaseRate ($904) and 3.5× the $927 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

45 CFR § 180 Primary-Source Lineage & Federal Verification Verified CMS CCN 360367

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (371848577-1841789427_university-hospitals-health-system_standardcharges.csv) Verify on CMS Medicare.gov (CCN 360367) ↗ CMS HCRIS Cost Reports ↗
Published MRF File371848577-1841789427_university-hospitals-health-system_standardcharges.csv
Publication / Vintage2026-07-14 · 3654.54 MB
Validated Rate Rows37,386,428 (CMS v3.0.0)
File Integrity Digestb61a16b62aa17d0a7626…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy