CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: St Charles Medical Center - Bend

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,211

about 1.3× the $927 Medicare rate · typically $910–$1,531

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,080

Below the fair price — a good deal

about $131 under the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,211 This hospital $1,080 Cash price $1,502 Hospital's list price $1,878

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Highest price of the 9 OR hospitals we have prices for — worth calling around.

Cheapest $126 Priciest $1,080

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,211 (about 1.3× the $927 Medicare rate). St Charles Medical Center - Bend charges insurers about $1,080, or about $1,502 in cash — below the fair price — a good deal. Located in Bend, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 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	$1,080 - $1,735	117%
Blue Cross Blue Shieldmajor	$1,188 - $2,955	128%
Aetnamajor	$1,080 - $1,634	117%
Cignamajor	$1,080 - $1,183	117%
Humanamajor	$1,080	117%
Kaiser Permanentemajor	$842 - $1,626	91%
Devoted Health	$1,080	117%
Health Net	$1,080 - $1,765	117%
Providence Health Plan	$1,315 - $1,643	142%
UniCare	$1,080	117%
WellCare	$1,080	117%
+ 67 smaller / regional plans	$650 - $2,955

Government programs also on file: Medicare, Medicaid, Military & VA.

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

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 1,502), 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 St Charles Medical Center - Bend 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 St Charles Medical Center - Bend

Compare: Upper endoscopy with biopsy at other OR hospitals

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