CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Duncan Regional Hospital, Inc

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,665

about 2.9× the $927 Medicare rate · typically $714–$4,010

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $2,665 Cash price $1,912 Hospital's list price $2,588

How we calculate the fair BaseRate →

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	$1,760	190%
Blue Cross Blue Shieldmajor	$2,516 - $3,950	272%
Aetnamajor	$2,200	237%
Cignamajor	$2,329	251%
Humanamajor	$956	103%
Friday Health	$2,437	263%
Health Net	$2,070	223%
Healthcare Highways	$1,139 - $1,682	123%
Medica	$1,087	117%
+ 2 smaller / regional plans	$2,329 - $2,381

Excludes 2 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 (about 1,912), 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 Duncan Regional Hospital, Inc 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 (%)

Enter your details and press estimate to compare.

Other Procedures at Duncan Regional Hospital, Inc

Compare: Upper endoscopy with biopsy at other OK hospitals

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