Upper endoscopy with biopsy
Facility: Mid-Columbia Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,101
- Cash Discount Price: $927
- vs. Medicare Baseline: 1.19x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $121 - $8,500 | 13% |
| Community Hp Mcr Adv - All Plans | $121 - $1,080 | 13% |
| Molina Mcr Adv | $121 - $1,080 | 13% |
| Tricare | $121 - $1,080 | 13% |
| Va Ccn Triwest - All Plans | $121 - $1,080 | 13% |
| Healthnet Mcr Adv | $123 - $1,101 | 13% |
| Humana | $124 - $1,134 | 13% |
| Moda Mcr Adv | $124 - $1,080 | 13% |
| Devoted Mcr Adv - All Plans | $130 - $2,879 | 14% |
| Employee Health Plan - All Plans | $133 - $1,943 | 14% |
| Molina - All Other Plans | $133 - $1,188 | 14% |
| Healthnet - All Other Plans | $192 | 21% |
| Cigna | $202 - $2,511 | 22% |
| Multiplan/Phcs - All Plans | $205 - $2,533 | 22% |
| Aetna | $229 - $2,461 | 25% |
| Coventry - All Plans | $247 - $2,399 | 27% |
| First Choice - All Plans | $251 - $2,533 | 27% |
| Providence Ppo - All Plans | $263 - $2,533 | 28% |
| Moda Health Plan - All Other Plans | $276 - $1,760 | 30% |
| Molina Mcaid | $622 - $1,386 | 67% |
| Amerigroup Mcaid - All Plans | $1,196 - $1,386 | 129% |
| Coordinated Care Mcaid - All Plans | $1,196 - $1,386 | 129% |
| Norocor - All Plans | $1,333 | 144% |
| UnitedHealthcare | $1,386 - $2,533 | 150% |
| Healthscape - All Plans | $2,133 | 230% |
| First Health - All Plans | $2,266 | 245% |
| Pacific Source - All Plans | $2,453 | 265% |
| Trpn - Three Rivers - All Plans | $2,533 | 273% |
| Ahp - Americas Hlth Plan - All Plans | $2,586 | 279% |