Upper GI endoscopy with biopsy at Saint Marys Hospital. CPT 43239.
What Saint Marys Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$1,004cash price (self-pay)
$1,626list price
$77.19–$3,225range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Allwell Medicaid Advantage | Medicaid | $93.67 |
| Kaiser Permanente Medicaid Advantage | Medicaid | $93.67 |
| Parkland Community Health Plan | Medicaid | $93.67 |
| Priority Partners | Medicaid | $93.67 |
| Healthfirst Medicaid Advantage | Medicaid | $93.67 |
| Molina Medicare Advantage | Medicare | $162 |
| Rx Allwin | Medicare | $162 |
| Community Pace At Home | Medicare | $162 |
| Kaiser Permanente Medicare Advantage | Medicare | $162 |
| Wellmed | Medicare | $162 |
| Mvp Medicare Advantage | Medicare | $162 |
| Aetna Medicare Assure Premier HMO D-Snp | Medicare | $162 |
| Elementcare | Medicare | $162 |
| Network Medicare Advantage | Medicare | $162 |
| Emblem Health Medicare Advantage | Medicare | $162 |
| Devoted Health Medicare Advantage | Medicare | $162 |
| Optimum Healthcare Medicare Advantage | Medicare | $162 |
| Innovative Integrated Health Community Plans | Medicare | $162 |
| Amerihealth Medicare | Medicare | $162 |
| Fresno Pace Medicare | Medicare | $162 |
| Cigna Medicare Advantage | Cigna Medicare Advantage | $219 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $219 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $219 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $222 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $224 |
| Wellcare Medicare | Wellcare Medicare Advantage | $224 |
| Wc Hireright | Workers Comp | $388 |
| Wc Health Management | Workers Comp | $388 |
| Wc Genex Care For Ohio | Workers Comp | $388 |
| Wc Society | Workers Comp | $388 |
Inpatient
$1,626cash price (self-pay)
$1,626list price
$95.32–$1,626range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lakeland Care Inc | Medicaid | $105 |
| Hennepin Health | Medicaid | $105 |
| Group Health Cooperative Medicaid | Medicaid | $105 |
| Icare Medicaid | Medicaid | $105 |
| Community Care Medicaid | Medicaid | $105 |
| Dean Health Medicaid | Medicaid | $105 |
| Childrens Comm Health Plan | Medicaid | $105 |
| Blue Cross - In (Anthem) Medicaid Advantage | Medicaid | $105 |
| Medicaid - In | Medicaid | $105 |
| Medicaid - Ia | Medicaid | $105 |
| Medicaid - Hi | Medicaid | $105 |
| Medicaid - FL | Medicaid | $105 |
| Medicaid - Ga | Medicaid | $105 |
| Medicaid - Nv | Medicaid | $105 |
| Medicaid - Nh | Medicaid | $105 |
| Medicaid - Me | Medicaid | $105 |
| Medicaid - Sc | Medicaid | $105 |
| Medicaid - Pa | Medicaid | $105 |
| Medicaid - Ri | Medicaid | $105 |
| Medicaid - Oh | Medicaid | $105 |
| Medicaid - Tn | Medicaid | $105 |
| Medicaid - TX | Medicaid | $105 |
| Blue Cross - IL Medicaid Advantage | Medicaid | $105 |
| Cenpatico | Medicaid | $105 |
| Keystone First Chip | Medicaid | $105 |
| Screening For Life | Medicaid | $105 |
| Medicaid - NY Ssl | Medicaid | $105 |
| Ucare Medicaid | Medicaid | $105 |
| Medicaid - Ne | Medicaid | $133 |
| Medicaid - Id | Medicaid | $141 |
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