CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Laredo Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $941
  • Cash Discount Price: $3,383
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Laredo Medical Center is $941. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,383. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.02x the Medicare baseline. Located in 1700 East Saunders, Laredo, TX.
Cash / Self-Pay
$3,383

Average discount available for prompt cash payment at this facility.

Insurance Median
$941

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: $3,383 (365%)
Insurance Median: $941 (102%)
Cash: $3,383 (365% of Medicare)
Ins. Median: $941 (102% 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 $342 37%
Medicaid / KanCare $352 - $714 38%
Molina $352 - $715 38%
UnitedHealthcare $352 - $4,017 38%
Blue Cross Blue Shield $359 - $3,073 39%
Amerigroup $370 40%
Cigna $370 - $6,998 40%
Superior $370 - $941 40%
Node Hospice Non Par Agree $870 94%
Humana $897 97%
Medicare (plans) $897 97%
Node Champva $911 98%
Node Ice Health Service Corps $911 98%
Node Va $911 98%
Tricare $911 98%
Triwest $911 98%
Aetna $923 - $8,175 100%
American Health $932 101%
Provider Partners Health Plan $938 101%
Node Amerigroup Mcr Adv $941 102%
Node Tihp Mcr Adv $941 102%
Node Wellpoint Mcr Adv $957 103%
Self Pay $987 107%
Multiplan Primary $1,035 112%
Industrial Rehab $1,048 113%
Node Us Dept Of Labor $1,139 123%
Node Molina Health Exchange $1,512 163%
Node Brookshire Brothers $1,594 172%
Node Brookshire Brothers Work Comp Tx $1,695 183%
Coventry Hcn Tx Work Comp $1,731 187%
Health Smart $1,731 - $9,866 187%
Node Superior Commercial Exchange $1,822 197%
Tx Work Comp $1,822 197%
Lonestar Athletic $2,000 216%
Imo Work Comp $2,096 226%
Node Naphcare $2,096 226%
Tx Workforce Commission $4,651 502%
Medical Control $11,698 1262%
Health Headquarters $11,980 1293%
Multiplan $12,262 1323%
Nha $12,403 1339%
Galaxy Health Network $12,474 1346%
Accountable Health Plans $12,685 1369%
Cchn $12,685 1369%
Nppn Plan Vista $12,685 1369%
Ppo Next $12,685 1369%
Mutual Of Omaha $13,390 1445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 East Saunders, Laredo, TX 78044
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals