CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Sanford Usd Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$981
about 1.1× the $927 Medicare rate · typically $941–$1,060
modeled estimate · not a bill or quote
What this hospital charges insurers
$953
About the fair price
about $28 under the fair price · 1.0× Medicare
Medicare pays $927 Fair price $981 This hospital $953 Cash price $2,540 Hospital's list price $3,175

How we calculate the fair BaseRate →

How this hospital compares to other SD hospitals

On the higher side — 7 of 8 other SD hospitals charge less.

Cheapest $123 Priciest $966

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

A fair price for a Upper endoscopy with biopsy is about $981 (about 1.1× the $927 Medicare rate). Sanford Usd Medical Center charges insurers about $953, or about $2,540 in cash — about the fair price. Located in Sioux Falls, SD.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 $966 - $2,797 104%
Blue Cross Blue Shieldmajor $402 - $1,140 43%
Aetnamajor $966 - $2,429 104%
Health Net $2,858 308%
HealthPartners $966 - $1,238 104%
Medica $2,140 - $2,289 231%
Sanford Health Plan $136 - $891 15%
Security Health Plan $1,746 188%
UCare $950 - $2,232 103%
+ 2 smaller / regional plans $950 - $2,858
Government programs also on file: Medicare.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals