CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Tennova Healthcare-Jefferson Memorial Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $850
  • Cash Discount Price: $3,295
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Tennova Healthcare-Jefferson Memorial Hospital is $850. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,295. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.92x the Medicare baseline. Located in 110 Hospital Drive, Jefferson City, TN.
Cash / Self-Pay
$3,295

Average discount available for prompt cash payment at this facility.

Insurance Median
$850

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $3,295 (356%)
Insurance Median: $850 (92%)
Cash: $3,295 (356% of Medicare)
Ins. Median: $850 (92% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Veterans Eval Services $325 35%
Amerigroup $543 59%
Medicaid / KanCare $644 69%
UnitedHealthcare $644 - $14,891 69%
Bluecare $663 - $988 72%
Tricare $782 84%
Humana $810 87%
Medicare (plans) $810 87%
Node Bluecare Plus Tn Mcr Adv $823 89%
Node Champva $823 89%
Node Hospice Non Par Agree $823 89%
Node Va $823 89%
Node Devoted Health Mcr Adv $826 89%
Node Farm Bureau Mcr Adv $826 89%
Aetna $834 - $9,560 90%
Blue Cross Blue Shield $834 - $3,023 90%
Node Healthspring Mcr Adv $834 90%
Node Amerigroup Mcr Adv $850 92%
Node Wellcare Mcr Adv $856 92%
Node Nhc Mcr Adv $891 96%
Node Us Dept Of Labor $1,029 111%
Three Rivers Work Comp Tn $1,125 121%
Novanet Work Comp Tn $1,392 150%
Occunet Work Comp Tn $1,406 152%
Tn Work Comp $1,406 152%
Ambetter / Centene $1,522 164%
Point Comfort Underwriters $1,781 192%
Cigna $1,908 206%
Self Pay $3,295 356%
Multiplan Complementary $11,764 1270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Hospital Drive, Jefferson City, TN 37760
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals