CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$934
about 1.0× the $927 Medicare rate · typically $360–$1,158
modeled estimate · not a bill or quote
What this hospital charges insurers
$921
About the fair price
about $13 under the fair price · 1.0× Medicare
Medicare pays $927 Fair price $934 This hospital $921 Cash price $2,966 Hospital's list price $4,943

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 $921

Black dot = this hospital, among the 9 PA 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 $934 (about 1.0× the $927 Medicare rate). UPMC Children's Hospital of Pittsburgh charges insurers about $921, or about $2,966 in cash — about the fair price. 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.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 $1,116 - $2,323 120%
Blue Cross Blue Shieldmajor $600 - $3,125 65%
Aetnamajor $140 - $2,719 15%
Cignamajor $965 - $2,719 104%
AmeriHealth $556 - $965 60%
Geisinger $611 - $2,222 66%
HealthPartners $575 62%
UPMC Health Plan $343 - $2,874 37%
+ 7 smaller / regional plans $517 - $4,449
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: One Children's Hospital Drive, Pittsburgh, PA 15224
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens