CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Curry General Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $581
Cash Discount Price: $612
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Curry General Hospital is $581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $612. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.63x the Medicare baseline. Located in 94220 Fourth Street, Gold Beach, OR.

Cash / Self-Pay

$612

Average discount available for prompt cash payment at this facility.

Insurance Median

$581

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)

Cash / Self-Pay: $612 (66%)

Insurance Median: $581 (63%)

Cash: $612 (66% of Medicare)

Ins. Median: $581 (63% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Covid19 Hrsa Uninsured Testing And Treatment Fund [2271]	$146	16%
Medicare (plans)	$146	16%
Tricare	$191	21%
Blue Cross Blue Shield	$312 - $612	34%
Medicaid / KanCare	$386 - $403	42%
Department Of Corrections [1051]	$398	43%
First Choice Health Admin [1294]	$402	43%
First Choice [528]	$402	43%
Coordinated Care Commercial [1649]	$520	56%
Pacificsource [1148]	$520	56%
Moda [512]	$525 - $551	57%
Multiplan [1131]	$557	60%
Asuris [1258]	$581	63%
Operating Engineers [1144]	$581	63%
Regence [1351]	$581 - $612	63%
Cigna	$600 - $612	65%
Coventry First Health Managed Care [1774]	$600	65%
Coventry Health [1046]	$600	65%
Providence Health Plan Plm Alt [1692]	$600	65%
Providence Health Plan [567]	$600	65%
Aetna	$612	66%
Employee Bene Admin Mgmt [525]	$612	66%
Geha [531]	$612	66%
Mailhandlers Benefit Pln [547]	$612	66%
Meritain [550]	$612	66%
Nw Sheet Metal Workers [597]	$612	66%
Trustmark [524]	$612	66%
UnitedHealthcare	$612	66%
Zenith Administrators [586]	$612	66%
Allcare Alt [2598]	$2,000	216%
Allcare [1695]	$2,000	216%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $612.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Curry General Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.