Upper endoscopy with biopsy
Facility: Legacy Salmon Creek Medical Center
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $671 compared to the $1,381 fair price benchmark.
4-Star CMS clinical quality rating paired with 0.49× fair market pricing.
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 | $7,385 | 797% |
| Blue Cross Blue Shieldmajor | $2,215 - $3,247 | 239% |
| Aetnamajor | $1,061 - $6,073 | 115% |
| Cignamajor | $1,112 - $6,796 | 120% |
| Kaiser Permanentemajor | $2,021 | 218% |
| Health Net | $1,071 - $4,275 | 116% |
| Moda Health | $1,132 | 122% |
| PacificSource | $1,092 | 118% |
| + 1 smaller / regional plan | $1,041 |
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 Legacy Salmon Creek Medical Center
Compare: Upper endoscopy with biopsy at other WA hospitals
- Lincoln Hospital · Davenport $124
- Arbor Health Morton Hospital · Morton $124
- Lake Chelan Community Hospital · Chelan $124
- Newport Community Hospital · Newport $142
- Jefferson Healthcare · Port Townsend $149
- Prosser Memorial Hospital · Prosser $153
- Kittitas Valley Community Hospital · Ellensburg $200
- Pullman Regional Hospital · Pullman $209
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Legacy Salmon Creek Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $375
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 = $375).
Self-Pay Cash Rate ($671) Beats Your Bill
Legacy Salmon Creek Medical Center's published 45 CFR § 180 self-pay cash rate is $671 (vs. $1,588 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,381 Fair BaseRate ($927 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($1,381).
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.