CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Parkland Health & Hospital System

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $2,185
Cash Discount Price: $2,541
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Parkland Health & Hospital System is $2,185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,541. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 2.36x the Medicare baseline. Located in 5200 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

$2,541

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,185

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: $2,541 (274%)

Insurance Median: $2,185 (236%)

Cash: $2,541 (274% of Medicare)

Ins. Median: $2,185 (236% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 236% of the Medicare baseline (a markup of 136%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Superior Health Plan [1402]	$370	40%
Wellpoint [1007]	$580 - $6,516	63%
Aetna	$609 - $6,842	66%
Cook Children Health Plan [1380]	$609 - $1,408	66%
Parkland Community Health Plan [1056]	$609 - $6,842	66%
Molina [1382]	$638 - $7,168	69%
Point Comfort Underwriters [1801]	$638 - $1,475	69%
Care Improvement Plus [1104]	$802 - $1,853	87%
Procare Advantage [2104]	$814 - $1,880	88%
Blue Cross Blue Shield	$1,195 - $6,385	129%
Cigna	$1,804 - $5,321	195%
Medicare (plans)	$1,862 - $1,955	201%
UnitedHealthcare	$1,862 - $5,915	201%
Wellcare Of Texas [1330]	$1,862	201%
Superior Healthplan [1383]	$2,267 - $5,237	245%
Great West Healthcare [1037]	$2,303 - $5,321	249%
Molina Aca [1337]	$2,660	287%
Triwest Healthcare Alliance [1409]	$6,651	718%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,541.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Parkland Health & Hospital System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.