CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Dickenson Community Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $517
  • Cash Discount Price: $377
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Dickenson Community Hospital is $517. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.56x the Medicare baseline. Located in 312 Hospital Drive, Clintwood, VA.
Cash / Self-Pay
$377

Average discount available for prompt cash payment at this facility.

Insurance Median
$517

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: $377 (41%)
Insurance Median: $517 (56%)
Cash: $377 (41% of Medicare)
Ins. Median: $517 (56% 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
UnitedHealthcare $171 - $1,641 18%
Blue Cross Blue Shield $311 - $1,641 34%
Aetna $492 - $1,900 53%
Amerigroup $492 53%
Managed Medicaire $492 53%
Medicare (plans) $492 53%
Sentara Health $492 - $605 53%
United Mine Workers Of America $492 53%
Humana $500 54%
Molina Healthcare $512 - $1,900 55%
Cigna $517 56%
Devoted Health Plan $517 56%
Nhc Advantage $517 56%
Medcost $574 62%
Ambetter / Centene $607 66%
Seven Corners, Inc. $1,641 177%
Optima Health $1,827 197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 312 Hospital Drive, Clintwood, VA 24228
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals