CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Williamson Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$771

about 0.8× the $927 Medicare rate · typically $264–$1,565

modeled estimate · not a bill or quote

What this hospital charges insurers

$361

Below the fair price — a good deal

about $410 under the fair price · 0.4× Medicare

Medicare pays $927 Fair price $771 This hospital $361

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

One of the lower prices — 6 of 8 other TN hospitals charge more for the same procedure.

Cheapest $125 Priciest $823

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

A fair price for a Upper endoscopy with biopsy is about $771 (about 0.8× the $927 Medicare rate). Williamson Medical Center charges insurers about $361 — below the fair price — a good deal. Located in Franklin, TN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$133 - $2,785	14%
Blue Cross Blue Shieldmajor	$133 - $1,392	14%
Aetnamajor	$133 - $898	14%
Cignamajor	$133 - $2,253	14%
Humanamajor	$133 - $2,886	14%
Ambetter (Centene)	$133 - $1,482	14%
Amerigroup	$133 - $925	14%
Devoted Health	$133 - $916	14%
Oscar Health	$2,654	286%
WellCare	$133 - $916	14%
+ 5 smaller / regional plans	$133 - $1,122

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, 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 Williamson Medical Center 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 Williamson Medical Center

Compare: Upper endoscopy with biopsy at other TN hospitals

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