CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: University Medical Center
Billing Code: 43239 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 43239
- Insurance Median: $373
- Cash Discount Price: $370
- vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at University Medical Center is $373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $370. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.40x the Medicare baseline. Located in 1800 W Charleston Blvd, Las Vegas, NV.
Cash / Self-Pay
$370
Average discount available for prompt cash payment at this facility.
Insurance Median
$373
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: $370 (40%)
Insurance Median: $373 (40%)
Cash: $370 (40% of Medicare)
Ins. Median: $373 (40% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $118 - $2,738 | 13% |
| Advantra Freedom | $118 - $1,036 | 13% |
| Stations Casinos | $131 - $1,686 | 14% |
| Mirage Las Vegas | $131 - $3,010 | 14% |
| Las Vegas Sand Corps | $131 - $1,516 | 14% |
| Pli Las Vegas | $131 - $1,686 | 14% |
| State of Nevada | $131 - $1,686 | 14% |
| P3 Health Partners | $131 - $1,686 | 14% |
| Healthcare Partners of Nevada | $131 - $1,036 | 14% |
| Las Vegas Metro Police Dept | $131 - $3,010 | 14% |
| Selecthealth | $131 - $1,534 | 14% |
| Cement Masons & Plasters H&W | $131 - $3,010 | 14% |
| Sierra Health and Life | $131 - $1,686 | 14% |
| Golden Nugget Hotel & Casino | $131 - $1,686 | 14% |
| Beech Street | $131 - $51,063 | 14% |
| Mgm Grand | $131 - $3,010 | 14% |
| Marshall Retail Group | $131 - $1,686 | 14% |
| Operating Engineers | $131 - $3,010 | 14% |
| Truline Corporation | $131 - $1,686 | 14% |
| City of Henderson | $131 - $3,010 | 14% |
| Golden Entertainment | $131 - $1,686 | 14% |
| VA Pc3 (VA Choice) | $131 - $1,036 | 14% |
| Rebel Oil Company | $131 - $1,686 | 14% |
| Blue Cross Blue Shield | $131 - $1,996 | 14% |
| Caesar's Entertainment | $131 - $3,010 | 14% |
| Wynn Resorts | $131 - $3,010 | 14% |
| UnitedHealthcare | $131 - $1,516 | 14% |
| Molina | $131 - $1,534 | 14% |
| Clark County Self Funded | $131 - $3,010 | 14% |
| Dignity Health | $131 - $1,686 | 14% |
| Venetian/Palazzo | $131 - $1,686 | 14% |
| City of North Las Vegas | $131 - $3,010 | 14% |
| Allwell | $131 - $1,036 | 14% |
| Resorts World Las Vegas | $131 - $3,010 | 14% |
| Clark County EPO | $131 - $3,010 | 14% |
| P3 Health Partners Nevada | $131 - $1,036 | 14% |
| Teacher's Health Trust | $131 - $1,686 | 14% |
| Aig | $131 - $51,063 | 14% |
| Arroweye Solutions | $131 - $1,686 | 14% |
| Alignment Health | $138 - $1,036 | 15% |
| Scan | $138 - $1,036 | 15% |
| Ambetter / Centene | $141 - $1,606 | 15% |
| Nevada Energy | $146 - $2,738 | 16% |
| Employee Painters Trust | $146 - $3,010 | 16% |
| Mail Handlers Benefit Plan | $146 - $2,738 | 16% |
| Clark County Firefighters 1908 | $146 - $3,010 | 16% |
| Geha | $146 - $533 | 16% |
| Coventry | $146 - $2,738 | 16% |
| Health Net | $147 - $5,141 | 16% |
| Three Rivers Provider Network | $147 - $3,513 | 16% |
| First Health | $147 - $3,513 | 16% |
| Ufcw Local 711 Retail Clerks | $155 - $3,010 | 17% |
| Teamsters Local 14 | $155 - $3,010 | 17% |
| Teamsters Local 631 | $155 - $3,010 | 17% |
| Electrical Workers | $155 - $3,010 | 17% |
| Laborers Health and Welfare | $155 - $3,010 | 17% |
| Southwest Carpenters H&W | $155 - $1,996 | 17% |
| Teamsters Local 986 | $155 - $3,010 | 17% |
| Bricklayers Local 13 | $155 - $3,010 | 17% |
| Sheet Metal Workers | $155 - $1,996 | 17% |
| Boyd Group | $155 - $3,010 | 17% |
| California Ironwork Field Welfare | $155 - $1,996 | 17% |
| So Ca Pipe Trades H&W | $155 - $1,996 | 17% |
| Plumbers & Pipefitters Loc 525 | $155 - $3,010 | 17% |
| Culinary Workers Hwf | $161 - $3,010 | 17% |
| Laughlin Coalition | $184 - $2,359 | 20% |
| Jw Marriott | $197 - $13,158 | 21% |
| Universal Health Network (Uhn) | $197 - $2,072 | 21% |
| Hometown Health Plan Nevada | $197 - $533 | 21% |
| Prominence Health Plan | $197 - $2,072 | 21% |
| Nevada Preferred Professionals | $197 - $2,072 | 21% |
| One Health Plan | $197 - $2,059 | 21% |
| Health Direct Partners | $216 - $1,668 | 23% |
| Zuffa | $283 - $3,629 | 31% |
| Cirque De Soleil | $294 - $2,060 | 32% |
| National Security Technologies | $294 - $2,060 | 32% |
| Kaiser | $294 - $2,060 | 32% |
| Cigna | $294 - $2,060 | 32% |
| Great West Healthcare | $294 - $2,060 | 32% |
| American Postal Workers Health Plan | $322 - $1,516 | 35% |
| Las Vegas Firefighters 1285 | $322 - $3,010 | 35% |
| Surest | $322 - $1,516 | 35% |
| Switch | $322 - $3,010 | 35% |
| Clark County Detention Center | $1,814 | 196% |
| Hometown Health Plan of Nevada | $2,059 | 222% |
| Nevada Hand | $3,010 | 325% |