Upper GI endoscopy with biopsy at Mercy Hospital Fort Smith. CPT 43239.
What Mercy Hospital Fort Smith publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$4,094cash price (self-pay)
$6,298list price
$112–$1,575range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross And Blue Shield [20053] | Hb Ftsm Managed Medicare | $112 |
| Indian Health Service [20198] | Hb Ftsm Medicare | $112 |
| Indian Health Service Contracted [320198] | Hb Ftsm Medicare | $112 |
| Summit Community Care Contracted [320368] | Hb Ftsm Summit | $297 |
| Summit Community Care [20368] | Hb Ftsm Ark Medicaid | $297 |
| Arkansas Department Of Health [20036] | Hb Ftsm Ark Medicaid | $297 |
| Medicaid [20240] | Hb Ftsm Ark Medicaid | $297 |
| Caresource Medicaid Contracted [320460] | Hb Ftsm Caresource Medicaid | $303 |
| Caresource Medicaid [20460] | Hb Ftsm Caresource Medicaid | $303 |
| Empower Healthcare Solutions Medicaid [20118] | Hb Ftsm Passe Empower | $377 |
| Empower Healthcare Solutions Medicaid Contracted [320118] | Hb Ftsm Pa | $377 |
| Arkansas Total Care [20039] | Hb Ftsm Passe Ar Total Care | $674 |
| Arkansas Total Care Contracted [320039] | Hb Ftsm Passe Ar Total Care | $674 |
| Medicaid [20240] | Hb Ftsm Mo Medicaid | $799 |
| Home State Medicaid Contracted [320189] | Hb Ftsm Managed Mo Mcd | $799 |
| Humana Contracted [320193] | Hb Ftsm Humana | $844 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Ftsm Medicare | $862 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Ftsm Medicare | $862 |
| Globalhealth Contracted [320145] | Hb Ftsm Managed Medicare | $862 |
| Essence Healthcare Medicare Contracted [320122] | Hb Ftsm Managed Medi | $862 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Ftsm Managed M | $862 |
| Humana Medicare Advantage Contracted [320194] | Hb Ftsm Humana Mcr | $862 |
| BCBS Medicare Advantage Contracted [320047] | Hb Ftsm Managed Medicare | $862 |
| Aetna Medicare Advantage Contracted [320010] | Hb Ftsm Managed Medicar | $862 |
| Pace Of The Ozarks [20518] | Hb Ftsm Managed Medicare | $862 |
| Jordan Valley Senior Care Pace [20515] | Hb Ftsm Managed Medicare | $862 |
| Valir Pace [20503] | Hb Ftsm Managed Medicare | $862 |
| Healthspring Medicare Advantage Contracted [320526] | Hb Ftsm Healthsp | $906 |
| Cigna Medicare Advantage Contracted [320072] | Hb Ftsm Healthspring Ci | $906 |
| Blue Cross And Blue Shield [20053] | Hb Ftsm BCBS Exchange | $957 |
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