CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Pullman Regional Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,101
  • Cash Discount Price: $1,733
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Pullman Regional Hospital is $1,101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,733. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.19x the Medicare baseline. Located in 835 S Bishop Blvd, Pullman, WA.
Cash / Self-Pay
$1,733

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,101

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: $1,733 (187%)
Insurance Median: $1,101 (119%)
Cash: $1,733 (187% of Medicare)
Ins. Median: $1,101 (119% 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
Medicaid / KanCare $79 - $1,139 9%
Community Care Ntwrk Mcare-All Plans $124 - $1,101 13%
Kaiser Mcare Advan $124 - $1,101 13%
Sterling Mcr Adv-All Plans $124 - $1,101 13%
Triwest - All Plans $124 - $1,101 13%
Wellcare Mcr Adv $136 - $1,200 15%
Blue Cross Blue Shield $143 - $2,988 15%
Humana $143 - $1,101 15%
Premera First - All Plans $183 - $2,296 20%
Aetna $188 - $2,988 20%
Community Health Plan Mcaid-All Plans $220 - $1,139 24%
Molina Hlthcare Mcaid-All Plans $220 - $1,139 24%
Wellcare Mcaid -All Other Plans $220 - $1,139 24%
Wellpoint Mcaid - All Plans $220 - $1,139 24%
First Choice - All Other Plans $223 - $2,830 24%
First Choice Admin $223 - $2,595 24%
Kaiser - All Other Plans $256 - $1,778 28%
Idaho Dshs-All Plans $383 - $1,289 41%
Admin Wsu Student-All Plans $793 - $2,673 86%
Multiplan - All Plans $793 - $2,673 86%
Asuris Nw Hlth-All Plans $840 - $2,830 91%
Cigna $840 - $2,830 91%
Focus Hlthcare - All Plans $840 - $2,830 91%
Northwest One - All Plans $840 - $2,830 91%
UnitedHealthcare $840 - $2,830 91%
Great West Hlth-All Plans $886 - $2,988 96%
Integrated Hp - All Plans $886 - $2,988 96%
Spokane Phco - All Plans $886 - $2,988 96%
Provider Network Of America-All Plans $914 - $3,082 99%
Single Case Agree - All Plans $2,296 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 S Bishop Blvd, Pullman, WA 99163
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals