Upper GI endoscopy with biopsy at Dodge County Hospital Authority. CPT 43239.
What Dodge County Hospital Authority publishes for this service, straight from its standard-charges file, last updated May 14, 2026.
Outpatient / ER
—cash price (self-pay)
$1,582list price
$100–$1,700range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Pathway/HMO | HMO | $100 |
| Peach State Medicaid | HMO | $155 |
| Amerigroup Medicaid | PPO | $281 |
| Aetna Medicare Advantage | HMO | $791 |
| UHC Medicare Advantage | HMO | $791 |
| Humana Medicare PPO | PPO | $791 |
| UHC Commercial | PPO | $1,036 |
| Aetna | PPO | $1,187 |
| Cigna | PPO | $1,424 |
| BCBS PPO/Par | PPO | $1,700 |
Inpatient
—cash price (self-pay)
$1,582list price
$1.00–$844range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | PPO | $1.00 |
| UHC Commercial | PPO | $1.00 |
| Peach State Medicaid | HMO | $1.00 |
| BCBS PPO/Par | PPO | $657 |
| Amerigroup Medicaid | PPO | $844 |
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