Upper GI endoscopy with biopsy at Lodi Memorial Hospital Association. CPT 43239.
What Lodi Memorial Hospital Association publishes for this service, straight from its standard-charges file, last updated August 2, 2026.
Outpatient / ER
$24.08cash price (self-pay)
$468list price
$35.00–$16,197range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Hp Mcal Pro Fee | Hp Mcal Pro Fee | $38.50 |
| Medcore(Omni Ipa) Op Only- All Plans | Medcore(Omni Ipa) Op Only- All | $122 |
| Hp Healthy Kids Pro Fee | Hp Healthy Kids Pro Fee | $130 |
| Kaiser Commercial - All Other Plans | Kaiser Commercial - All Other Pl | $168 |
| Networks By Design- All Plans | Networks By Design- All Plans | $172 |
| Healthnet- All Other Plans | Healthnet- All Other Plans | $181 |
| Kaiser Mcal | Kaiser Mcal | $234 |
| Medi-Cal | Medi-Cal | $234 |
| First Health- All Plans | First Health- All Plans | $241 |
| Multiplan- All Plans | Multiplan- All Plans | $275 |
| Western Growers- All Plans | Western Growers- All Plans | $275 |
| Hp Of San Joaquin Mcal | Hp Of San Joaquin Mcal | $293 |
| Beech Street- All Plans | Beech Street- All Plans | $310 |
| Cigna- All Plans | Cigna- All Plans | $310 |
| Hp Of San Joaquin PPO - All Other Plans | Hp Of San Joaquin PPO - All | $327 |
| Healthnet Mcal | Healthnet Mcal | $335 |
| Blue Cross Exchange | Blue Cross Exchange | $338 |
| Celtic Ins Company - All Plans | Celtic Ins Company - All Plans | $344 |
| Three Rivers Provider Network- All Plans | Three Rivers Provider Netwo | $421 |
| Blue Cross Non-Mcs - All Other Plans | Blue Cross Non-Mcs - All Other | $427 |
| Bc Mcal | Bc Mcal | $463 |
| Blue Shield Epn - All Other Plans | Blue Shield Epn - All Other Plans | $501 |
| Blue Shield Non-Epn | Blue Shield Non-Epn | $519 |
| Alignment Health Plan (Ahp)-All Plans | Alignment Health Plan (Ahp)-Al | $1,196 |
| Blue Shield Mcare Adv | Blue Shield Mcare Adv | $1,196 |
| Healthnet Mcare | Healthnet Mcare | $1,196 |
| Hp Of San Joaquin Mcr Adv | Hp Of San Joaquin Mcr Adv | $1,196 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $1,196 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $1,196 |
| Tricare Blue Shield - All Plans | Tricare Blue Shield - All Plans | $1,196 |
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