CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Medical City Dallas Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $985
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Medical City Dallas Hospital is $985. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.06x the Medicare baseline. Located in 7777 Forest Lane, Dallas, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$985

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%)
Insurance Median: $985 (106%)
Ins. Median: $985 (106% 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
Texas Health Network $330 36%
Cook Childrens Health Plan $335 36%
Parkland Community Health Plan $335 36%
United $335 - $5,047 36%
Amerigroup $352 38%
Cigna $352 - $3,816 38%
Molina $368 - $375 40%
Aetna $402 - $4,332 43%
Humana $419 - $4,926 45%
Wellmed $916 99%
Superior Health Plan $948 102%
Blue Cross Blue Shield $1,022 - $1,941 110%
Fidelis Securecare $1,995 215%
Healthcare Highways Ntx $2,047 221%
Healthcare Highways $2,129 230%
Evry Health $2,356 254%
Curative Administrators $2,613 282%
Multiplan Phcs $3,972 429%
Oscar $4,723 510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7777 Forest Lane, Dallas, TX 75230
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals