Upper GI endoscopy with biopsy at Good Samaritan Hospital. CPT 43239.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$21.52–$14,449range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Physicians Medical Group | MCD | $50.20 |
| Anthem | Medi-Cal | $55.22 |
| Physician Health Network | MGMCD | $55.22 |
| Santa Clara IPA COMM | COMM | $450 |
| Santa Clara Family Health Plan | Medicaid | $1,275 |
| MedCare Partners | MGMCR | $1,334 |
| MultiPlan | Primary | $2,638 |
| Bright Health | COMM | $3,680 |
| Cigna | LocalPlus | $4,702 |
| Anthem | ExchangeEPO | $4,758 |
| Cigna | HMO | $5,002 |
| Cigna | POS | $5,002 |
| Cigna | PPO | $5,002 |
| Anthem | BlueConnection | $5,022 |
| Anthem | COMM | $5,022 |
| Aetna | AWH | $6,193 |
| Aetna | HMO | $6,319 |
| United | AllPayerAppendix | $7,848 |
| Blue Shield | COMM | $10,378 |
| Blue Shield | EPN | $10,378 |
| Aetna | PPO | $14,449 |
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