Upper endoscopy with biopsy
Facility: Affiliate of Vitruvian Health
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $872 compared to the $914 fair price benchmark.
2-Star CMS clinical quality rating paired with 0.95× fair market pricing.
Highest price of the 9 TN hospitals we have prices for — worth calling around.
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 $914 (about 1.0× the $927 Medicare rate). Affiliate of Vitruvian Health charges insurers about $872 — about the fair price. Located in Cleveland, TN.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
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 | $872 - $2,278 | 94% |
| Blue Cross Blue Shieldmajor | $710 - $1,504 | 77% |
| Aetnamajor | $856 | 92% |
| Cignamajor | $1,419 - $1,531 | 153% |
| Ambetter (Centene) | $1,412 | 152% |
| WellCare | $864 | 93% |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Affiliate of Vitruvian Health
Compare: Upper endoscopy with biopsy at other TN hospitals
- Metro Nashville General Hospital · Nashville $125
- Rhea Medical Center · Dayton $258
- Erlanger Bledsoe Hospital · Pikeville $329
- St Jude Childrens Research Hospital · Memphis $333
- Williamson Medical Center · Franklin $361
- Erlanger Medical Center · Chattanooga $369
- University Health System, Inc · Knoxville $495
- Haywood County Community Hospital · Brownsville $553
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Affiliate of Vitruvian Health (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $760
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $760).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Affiliate of Vitruvian Health's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $914 Fair BaseRate ($927 Medicare)
Your bill ($2,093) is $1,179 above the denoised Fair BaseRate ($914) and 2.3× the $927 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.