Upper endoscopy with biopsy
Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $348 compared to the $1,035 fair price benchmark.
4-Star CMS clinical quality rating paired with 0.34× fair market pricing.
Highest price of the 9 TX hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.
Note: The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.
A fair price for a Upper endoscopy with biopsy is about $1,035 (about 1.1× the $927 Medicare rate). UT of Texas Southwestern University Hospital - William P. Clements Jr. charges insurers about $348, or about $2,594 in cash — below the fair price — a good deal. Located in Dallas, TX.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 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 | $110 - $6,261 | 12% |
| Blue Cross Blue Shieldmajor | $110 - $3,472 | 12% |
| Aetnamajor | $126 - $3,626 | 14% |
| Cignamajor | $540 - $3,821 | 58% |
| Humanamajor | $139 - $975 | 15% |
| Ambetter (Centene) | $136 | 15% |
| Molina | $110 - $984 | 12% |
| + 7 smaller / regional plans | $110 - $3,632 |
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 UT of Texas Southwestern University Hospital - William P. Clements Jr.
Compare: Upper endoscopy with biopsy at other TX hospitals
- Seymour Hospital · Seymour $100
- Comanche County Medical Center · Comanche $121
- Sweeny Community Hospital · Sweeny $123
- PAM Specialty Hospital of San Antonio Medical Center · San Antonio $132
- PAM Specialty Hospital of Texarkana North · Texarkana $141
- Ward Memorial Hospital · Monahans $218
- Memorial Medical Center · Port Lavaca $228
- University of Texas M. D. Anderson Cancer Center · Houston $255
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at UT of Texas Southwestern University Hospital - William P. Clements Jr. (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,883
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 = $1,883).
Self-Pay Cash Rate ($2,594) Beats Your Bill
UT of Texas Southwestern University Hospital - William P. Clements Jr.'s published 45 CFR § 180 self-pay cash rate is $2,594 (vs. $348 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,035 Fair BaseRate ($927 Medicare)
Your bill ($5,188) is $4,153 above the denoised Fair BaseRate ($1,035) and 5.6× 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.