CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Maury Regional Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $873
  • Cash Discount Price: $1,615
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Maury Regional Hospital is $873. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,615. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.94x the Medicare baseline. Located in 1224 Trotwood Ave, Columbia, TN.
Cash / Self-Pay
$1,615

Average discount available for prompt cash payment at this facility.

Insurance Median
$873

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: $1,615 (174%)
Insurance Median: $873 (94%)
Cash: $1,615 (174% of Medicare)
Ins. Median: $873 (94% 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
Wellpoint $713 - $1,055 77%
Wellpoint Tci $713 77%
Humana $725 - $845 78%
UnitedHealthcare $770 - $4,326 83%
Blue Cross Blue Shield $784 - $1,117 85%
Cigna $794 - $2,379 86%
Farm Bureau Health Plans $794 - $845 86%
Medicare (plans) $794 - $845 86%
Aetna $817 - $3,093 88%
Nhc $817 - $870 88%
Wellcare Harmony Health $817 - $870 88%
American Health Plans $818 - $845 88%
Medrisk $1,184 128%
State Of Tennessee $1,184 128%
Ambetter / Centene $1,479 - $1,996 160%
Wayne County Jail $1,718 185%
Oscar $2,024 - $2,155 218%
Lawrence County Jail $2,578 278%
Lewis County Jail $2,578 278%
Marshall County Jail $2,578 278%
Beech Street $2,750 297%
Multiplan $2,750 297%
Phcs $2,750 297%
Firsthealth $3,300 356%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1224 Trotwood Ave, Columbia, TN 38401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals