CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Mid-Columbia Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$262

about 0.3× the $927 Medicare rate · typically $198–$817

modeled estimate · not a bill or quote

What this hospital charges insurers

$263

About the fair price

about $1 over the fair price · 0.3× Medicare

Medicare pays $927 Fair price $262 This hospital $263 Cash price $927 Hospital's list price $1,931

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

A typical price — 4 charge more and 4 charge less, among the 9 OR hospitals compared.

Cheapest $126 Priciest $349

Black dot = this hospital, among the 9 OR 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 $262 (about 0.3× the $927 Medicare rate). Mid-Columbia Medical Center charges insurers about $263, or about $927 in cash — about the fair price. Located in The Dalles, OR.

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	$1,386 - $2,533	150%
Blue Cross Blue Shieldmajor	$121 - $8,500	13%
Aetnamajor	$229 - $2,461	25%
Cignamajor	$202 - $2,511	22%
Humanamajor	$124 - $1,134	13%
Amerigroup	$1,196 - $1,386	129%
Devoted Health	$130 - $2,879	14%
Health Net	$123 - $1,101	13%
Moda Health	$124 - $1,760	13%
Molina	$121 - $1,386	13%
+ 8 smaller / regional plans	$121 - $2,586

Government programs also on file: Military & VA.

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 (about 927), 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 Mid-Columbia Medical Center 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 Mid-Columbia Medical Center

Compare: Upper endoscopy with biopsy at other OR hospitals

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