Upper endoscopy with biopsy
Facility: Froedtert Memorial Lutheran Hospital
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $953 compared to the $1,303 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.73× fair market pricing.
Highest price of the 9 WI hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.
A fair price for a Upper endoscopy with biopsy is about $1,303 (about 1.4× the $927 Medicare rate). Froedtert Memorial Lutheran Hospital charges insurers about $953 — below the fair price — a good deal. Located in Milwaukee, WI.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 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 | $953 - $6,766 | 103% |
| Blue Cross Blue Shieldmajor | $953 - $4,258 | 103% |
| Aetnamajor | $972 | 105% |
| Humanamajor | $953 | 103% |
| Health Net | $4,714 | 509% |
| HealthPartners | $953 | 103% |
| Molina | $953 | 103% |
| Priority Health | $953 | 103% |
| Quartz | $953 | 103% |
| Security Health Plan | $953 | 103% |
| WellCare | $972 | 105% |
| + 5 smaller / regional plans | $953 - $4,352 |
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 Froedtert Memorial Lutheran Hospital
Compare: Upper endoscopy with biopsy at other WI hospitals
- Crossing Rivers Health Medical Center · Prairie Du Chien $116
- Richland Hospital · Richland Center $133
- Memorial Hospital of Lafayette County · Darlington $145
- Stoughton Hospital · Stoughton $155
- Edgerton Hospital and Health Services · Edgerton $170
- Grant Regional Health Center · Lancaster $185
- Tomah Memorial Hospital · Tomah $192
- Langlade Hospital · Antigo $278
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Froedtert Memorial Lutheran Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $830
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 = $830).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Froedtert Memorial Lutheran Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $1,303 Fair BaseRate ($927 Medicare)
Your bill ($2,287) is $984 above the denoised Fair BaseRate ($1,303) and 2.5× the $927 Medicare rate.
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.