Upper GI endoscopy with biopsy at UCLA Santa Monica Medical Center. CPT 43239.
What UCLA Santa Monica Medical Center publishes for this service, straight from its standard-charges file, last updated March 29, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$1,167–$3,348range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare | Medicare | $1,167 |
| Redlands Community Medicare | Medicare | $1,167 |
| St. Jude | Medicare HMO | $1,167 |
| TriWest Healthcare Alliance | Other Government | $1,167 |
| UCLA Health Medicare Advantage Plan | Medicare Advantage | $1,167 |
| Health Plan of Nevada Medicare | Medicare | $1,177 |
| Blue Shield | Medicare Advantage | $1,191 |
| LA Care DSNP | Medicare HMO | $1,191 |
| Monarch | Medicare | $1,191 |
| UHC Mediare Advantage | Medicare Advantage | $1,191 |
| Anthem Vivity-Anthem HMO | All Products-HMO | $1,298 |
| Providence Healthcare | Medicare | $1,310 |
| Torrance Memorial Medicare | HMO-Medicare | $1,310 |
| Central Health Plan | Medicare HMO | $1,359 |
| HealthSmart | Workers Compensation | $1,400 |
| Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $1,457 |
| LA Care Covered CA | HMO | $1,586 |
| SCAN | Medicare | $1,608 |
| Centivo | PPO | $2,800 |
| Health Plan of Nevada Commercial | All Products | $3,250 |
| Optum | Medicare | $3,348 |
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