CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Dallas Regional Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $979
  • Cash Discount Price: $906
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Dallas Regional Medical Center is $979. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $906. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.06x the Medicare baseline. Located in 1011 North Galloway Avenue, Mesquite, TX.
Cash / Self-Pay
$906

Average discount available for prompt cash payment at this facility.

Insurance Median
$979

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: $906 (98%)
Insurance Median: $979 (106%)
Cash: $906 (98% of Medicare)
Ins. Median: $979 (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
Careworks Fka (Rockport Community Network) Workercomp $861 93%
Blue Cross Blue Shield $879 - $1,768 95%
UnitedHealthcare $892 - $1,026 96%
Aetna $907 - $1,900 98%
Care N Care Insurance Company $907 98%
Cigna $907 - $934 98%
Medicare (plans) $907 98%
Superior Health Plan/Wellcare $907 - $1,179 98%
Texas Bluebonnett Health Plan $907 - $1,496 98%
Tricare $907 98%
Usa Senior Care Network $907 98%
Wellmed $907 98%
Wellpoint Amerigroup $907 98%
Molina $952 103%
Multiplan $952 103%
Provider Partners Health Plan $952 103%
Imperial Insurance Companies Mcr $961 104%
American Health Plan $997 108%
Hi Card $1,133 122%
Worker Compensation $1,179 - $1,813 127%
American Correction Healthcare $1,251 135%
Employee Direct Healthcare $1,269 137%
Total Plans Srvices $1,269 137%
Wellpath $1,315 142%
Corporate Remedies Workers Comp $1,360 147%
Naphcare -Prison $1,405 152%
Elap Services $1,496 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1011 North Galloway Avenue, Mesquite, TX 75149
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals