CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Dunes Surgical Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,436

about 1.5× the $927 Medicare rate · typically $696–$1,436

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,314

About the fair price

about $122 under the fair price · 1.4× Medicare

Medicare pays $927 Fair price $1,436 This hospital $1,314 Cash price $1,388 Hospital's list price $2,182

How we calculate the fair BaseRate →

How this hospital compares to other SD hospitals

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

Cheapest $123 Priciest $1,314

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 $1,436 (about 1.5× the $927 Medicare rate). Dunes Surgical Hospital charges insurers about $1,314, or about $1,388 in cash — about the fair price. Located in Dakota Dunes, 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✓ Cigna AetnaHumanaKaiser 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	$372 - $1,746	40%
Blue Cross Blue Shieldmajor	$944 - $1,526	102%
Cignamajor	$1,527	165%
Amerigroup	$956	103%
HealthPartners	$2,117	228%
Molina	$953	103%
Oscar Health	$1,101	119%
Sanford Health Plan	$1,855	200%
+ 5 smaller / regional plans	$925 - $1,855

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,388), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Dunes Surgical Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Dunes Surgical Hospital

Compare: Upper endoscopy with biopsy at other SD hospitals

Insurance negotiated median for the same procedure, sorted lowest first.