CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: The Miriam Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$1,734
about 1.9× the $927 Medicare rate · typically $976–$1,947
modeled estimate · not a bill or quote
What this hospital charges insurers
$1,864
About the fair price
about $130 over the fair price · 2.0× Medicare
Medicare pays $927 Fair price $1,734 This hospital $1,864 Cash price $3,153 Hospital's list price $3,153

How we calculate the fair BaseRate →

How this hospital compares to other RI hospitals

On the higher side — 3 of 4 other RI hospitals charge less.

Cheapest $965 Priciest $1,875

Black dot = this hospital, among the 5 RI hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,734 (about 1.9× the $927 Medicare rate). The Miriam Hospital charges insurers about $1,864, or about $3,153 in cash — about the fair price. Located in Providence, RI.

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 $826 - $4,099 89%
Blue Cross Blue Shieldmajor $835 - $1,956 90%
Aetnamajor $1,043 113%
Cignamajor $5,727 618%
Harvard Pilgrim $3,024 326%
Tufts Health Plan $2,563 277%
+ 1 smaller / regional plan $1,864

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 164 Summit Avenue, Providence, RI 02906
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals