Upper GI endoscopy with biopsy at Providence Little Co of Mary Med Center San Pedro. CPT 43239.
What Providence Little Co of Mary Med Center San Pedro publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$508cash price (self-pay)
$1,452list price
$1,167–$14,674range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $1,167 |
| Humana | Medicare Managed Care Plan | $1,190 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $1,222 |
| Caremore | Medicare Managed Care Plan | $1,283 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $1,376 |
| La Care Health Plan | Covered Ca Exchange | $1,516 |
| Blue Shield | Medicare Managed Care Plan | $1,528 |
| Healthnet | Ambetter Hmo | $2,158 |
| Healthnet | Ambetter Ppo | $2,496 |
| Unitedhealthcare | Select/Navigate Hmo | $2,669 |
| Healthnet | Blue And Gold Other Commercial Plan | $2,719 |
| Unitedhealthcare | All Commercial Plans | $3,023 |
| Blue Shield | Epn/Ifp Benefit Exchange | $3,511 |
| Blue Cross | All Commercial Plans | $3,664 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $3,826 |
| Blue Shield | Hmo | $4,121 |
| Blue Shield | Ppo/Epo | $4,247 |
| Healthnet | All Commercial Plans | $4,385 |
| Cigna | Oa/Oap Hmo/Pos | $6,826 |
| Cigna | Ppo | $14,674 |
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All common services at Providence Little Co of Mary Med Center San Pedro