CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Providence St Peter Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,899

about 2.0× the $927 Medicare rate · typically $1,268–$1,909

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,820

About the fair price

about $79 under the fair price · 2.0× Medicare

Medicare pays $927 Fair price $1,899 This hospital $1,820 Cash price $1,631 Hospital's list price $3,137

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

Highest price of the 9 WA hospitals we have prices for — worth calling around.

Cheapest $124 Priciest $1,820

Black dot = this hospital, among the 9 WA hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,899 (about 2.0× the $927 Medicare rate). Providence St Peter Hospital charges insurers about $1,820, or about $1,631 in cash — about the fair price. Located in Olympia, WA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

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	$887 - $4,075	96%
Blue Cross Blue Shieldmajor	$1,127 - $1,878	122%
Aetnamajor	$1,074 - $6,260	116%
Cignamajor	$5,180	559%
Humanamajor	$1,147	124%
Kaiser Permanentemajor	$1,043 - $3,319	113%
Molina	$1,763	190%
Providence Health Plan	$3,406	368%
+ 3 smaller / regional plans	$1,669 - $3,694

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,631), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Providence St Peter Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Providence St Peter Hospital

Compare: Upper endoscopy with biopsy at other WA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.