CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Camc Greenbrier Valley Medical Center, Inc

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$587

about 0.6× the $927 Medicare rate · typically $153–$1,174

modeled estimate · not a bill or quote

What this hospital charges insurers

$99

Below the fair price — a good deal

about $488 under the fair price · 0.1× Medicare

Medicare pays $927 Fair price $587 This hospital $99 Cash price $435 Hospital's list price $435

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

Lowest price of the 9 WV hospitals we have prices for — a strong deal.

Cheapest $99 Priciest $467

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $587 (about 0.6× the $927 Medicare rate). Camc Greenbrier Valley Medical Center, Inc charges insurers about $99, or about $435 in cash — below the fair price — a good deal. Located in Ronceverte, WV.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$99 - $348	11%
Blue Cross Blue Shieldmajor	$93 - $173	10%
Aetnamajor	$93 - $426	10%
Humanamajor	$99 - $392	11%
CareSource	$93 - $348	10%
UniCare	$93	10%
+ 7 smaller / regional plans	$87 - $392

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 435), 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 Camc Greenbrier Valley Medical Center, Inc 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 Camc Greenbrier Valley Medical Center, Inc

Compare: Upper endoscopy with biopsy at other WV hospitals

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