Upper endoscopy with biopsy
Facility: Womans Hospital of Texas,The
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $1,257 compared to the $1,601 fair price benchmark.
4-Star CMS clinical quality rating paired with 0.79× 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.
A fair price for a Upper endoscopy with biopsy is about $1,601 (about 1.7× the $927 Medicare rate). Womans Hospital of Texas,The charges insurers about $1,257 — below the fair price — a good deal. Located in Houston, 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 | $359 - $3,262 | 39% |
| Blue Cross Blue Shieldmajor | $1,085 - $1,257 | 117% |
| Aetnamajor | $423 - $2,585 | 46% |
| Cignamajor | $2,957 - $3,810 | 319% |
| Humanamajor | $419 - $4,690 | 45% |
| Amerigroup | $352 | 38% |
| Fidelis Care | $2,115 | 228% |
| Health Net | $328 | 35% |
| Healthcare Highways | $2,434 | 263% |
| Molina | $368 | 40% |
| Oscar Health | $2,979 | 321% |
| WellMed | $916 | 99% |
| + 4 smaller / regional plans | $375 - $4,255 |
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 Womans Hospital of Texas,The
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 Womans Hospital of Texas,The (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,095
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 = $1,095).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Womans Hospital of Texas,The's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $1,601 Fair BaseRate ($927 Medicare)
Your bill ($3,017) is $1,416 above the denoised Fair BaseRate ($1,601) and 3.3× 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.