Upper endoscopy with biopsy
Facility: Christus Santa Rosa Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $907
- Cash Discount Price: $1,217
- vs. Medicare Baseline: 0.98x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Amerigroup | $213 - $951 | 23% |
| Community First | $213 - $672 | 23% |
| Aetna | $335 - $2,594 | 36% |
| Blue Cross Blue Shield | $335 - $1,077 | 36% |
| Driscoll Children'S Health Plan | $335 | 36% |
| El Paso First | $335 | 36% |
| First Care | $335 | 36% |
| Molina | $335 - $880 | 36% |
| Superior | $335 - $880 | 36% |
| Texas Childrens Health Plan | $352 | 38% |
| UnitedHealthcare | $363 - $3,326 | 39% |
| Community First Health Plan | $852 - $2,689 | 92% |
| Allwell | $880 | 95% |
| Christus Health | $880 - $1,232 | 95% |
| Coventry | $880 | 95% |
| Humana | $880 - $1,737 | 95% |
| Texas Healthspring | $880 | 95% |
| Triwest | $880 | 95% |
| Wellcare | $880 | 95% |
| Provider Partners Health Plan | $907 | 98% |
| Texas Independence Health Plan | $907 | 98% |
| Shared Health Insurance Company | $924 | 100% |
| Us Imaging Network | $942 | 102% |
| Devoted Health Plan | $951 | 103% |
| Imperial Health Plan | $968 | 104% |
| Medicare (plans) | $968 | 104% |
| Procare Advantage | $968 | 104% |
| Christian Brothers Services | $976 - $3,082 | 105% |
| Employer Direct | $1,056 | 114% |
| Gilsbar Inc. | $1,144 | 123% |
| First Health | $1,154 - $3,642 | 125% |
| Healthsmart | $1,154 - $4,482 | 125% |
| Multiplan | $1,154 - $3,642 | 125% |
| Phcs | $1,154 - $3,642 | 125% |
| Medicus Internatiaonal | $1,331 - $4,202 | 144% |
| Beech Street | $1,420 - $4,482 | 153% |
| Health Management Network | $1,420 - $4,482 | 153% |
| Provider Select | $1,420 - $4,482 | 153% |
| National Choicecare | $1,686 - $5,323 | 182% |
| Naphcare Inc. | $1,761 | 190% |
| Five Point Credit Union | $4,020 | 434% |
| Healthcare Highways | $4,115 | 444% |
| Cigna | $4,549 - $5,774 | 491% |