CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Hancock County Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,184
  • Cash Discount Price: $377
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Hancock County Hospital is $1,184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.28x the Medicare baseline. Located in 1519 Main Street Hwy 33, Sneedville, TN.
Cash / Self-Pay
$377

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,184

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: $377 (41%)
Insurance Median: $1,184 (128%)
Cash: $377 (41% of Medicare)
Ins. Median: $1,184 (128% 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
UnitedHealthcare $106 - $1,425 11%
Blue Cross Blue Shield $311 - $1,641 34%
Sentara Health $424 - $1,165 46%
Amerigroup $639 - $1,165 69%
Medcost $781 84%
Aetna $1,165 - $1,439 126%
Ambetter / Centene $1,165 126%
Managed Medicaire $1,165 126%
Medicare (plans) $1,165 126%
United Mine Workers Of America $1,165 126%
Wellcare $1,165 - $1,641 126%
Humana $1,184 128%
Cigna $1,221 - $1,223 132%
Devoted Health Plan $1,223 132%
Molina Healthcare $1,223 - $1,452 132%
Nhc Advantage $1,223 132%
First Health Coventry $1,313 142%
Optima Health $1,426 154%
Seven Corners, Inc. $1,641 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1519 Main Street Hwy 33, Sneedville, TN 37869
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals