CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: West Penn Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$279
about 0.3× the $927 Medicare rate · typically $222–$625
modeled estimate · not a bill or quote
What this hospital charges insurers
$238
Below the fair price — a good deal
about $41 under the fair price · 0.3× Medicare
Medicare pays $927 Fair price $279 This hospital $238 Cash price $103 Hospital's list price $383

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $147 Priciest $238

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

A fair price for a Upper endoscopy with biopsy is about $279 (about 0.3× the $927 Medicare rate). West Penn Hospital charges insurers about $238, or about $103 in cash — below the fair price — a good deal. Located in Pittsburgh, PA.

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 $215 - $3,165 23%
Blue Cross Blue Shieldmajor $119 - $2,289 13%
Aetnamajor $178 - $2,985 19%
Cignamajor $218 - $2,993 24%
Humanamajor $956 103%
AmeriHealth $156 - $947 17%
Geisinger $215 - $450 23%
Medical Mutual $2,993 323%
Molina $983 106%
+ 5 smaller / regional plans $128 - $902
Government programs also on file: Medicare.

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Facility Profile & Credentials

  • Address: 4800 Friendship Avenue, Pittsburgh, PA 15224
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals