Upper endoscopy with biopsy
Facility: Anmed Health
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $200
- Cash Discount Price: $291
- vs. Medicare Baseline: 0.22x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $91 - $314 | 10% |
| Absolute Total Care [58] | $93 - $321 | 10% |
| Humana | $96 - $883 | 10% |
| Select Health Of Sc [637] | $96 - $280 | 10% |
| Aetna | $125 - $528 | 13% |
| Blue Cross Blue Shield | $125 - $587 | 13% |
| Devoted Health Alt Payer [9401] | $125 - $336 | 13% |
| Devoted Health [94] | $125 - $336 | 13% |
| Medicare (plans) | $125 - $396 | 13% |
| UnitedHealthcare | $125 - $583 | 13% |
| Vaccn - Va Community Care Network [16] | $125 - $330 | 13% |
| Veterans Administration [633] | $125 - $330 | 13% |
| Cigna | $128 - $576 | 14% |
| Molina Dual Options Alt Payer [1501] | $128 - $340 | 14% |
| Molina Dual Options [15] | $128 - $340 | 14% |
| Absolute Total Care Mcr Plans Alt Payer [4101] | $129 - $341 | 14% |
| Absolute Total Care Mcr Plans [41] | $129 - $341 | 14% |
| Blue Choice Health Plan [922] | $130 - $462 | 14% |
| Champva [604] | $131 - $349 | 14% |
| First Choice Vip Careplus Alt Payer [3301] | $131 - $346 | 14% |
| First Choice Vip [33] | $131 - $346 | 14% |
| Nhc Advantage Alt Payer [6101] | $131 - $346 | 14% |
| Nhc Advantage [61] | $131 - $346 | 14% |
| Tricare | $131 - $349 | 14% |
| Bright Health Alt Payer [1001] | $133 - $396 | 14% |
| Ambetter / Centene | $178 - $471 | 19% |
| Bright Health [11] | $178 - $440 | 19% |
| First Choice Next [96] | $181 - $478 | 20% |
| Molina Marketplace [97] | $181 - $478 | 20% |
| Mail Handlers Benefit Plan [327] | $200 - $528 | 22% |
| Rural Carrier Benefit Plan [406] | $200 - $528 | 22% |
| Workers Compensation [622] | $202 - $540 | 22% |
| Edison Health Solutions [95] | $218 - $577 | 24% |
| Healthscope [98] | $218 - $577 | 24% |
| Geha [302] | $224 - $583 | 24% |
| Golden Rule Ins Co [584] | $224 - $583 | 24% |
| Nalc Health Benefit Plan [291] | $241 - $576 | 26% |
| Employee Benefit Management Services [869] | $279 - $288 | 30% |
| Medcost [206] | $284 - $704 | 31% |
| Preferred Administrators [19] | $349 - $360 | 38% |
| Planned Administrators [886] | $465 | 50% |
| Thomas Cooper & Company [315] | $465 | 50% |
| Phcs [940] | $511 - $528 | 55% |