Upper GI endoscopy with biopsy at Samuel Mahelona Memorial Hospital. CPT 43239.
What Samuel Mahelona Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$820cash price (self-pay)
$1,330list price
$125–$1,131range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AlohaCare | Medicare | $125 |
| Ohana Health Plan | Medicare | $125 |
| Devoted Health | Medicare | $137 |
| AlohaCare | Medicaid | $139 |
| Ohana Health Plan | Medicaid | $139 |
| Kaiser Permanente | Commercial | $238 |
| Hawaii Medical Service Association | Medicare | $242 |
| Kaiser Permanente | Medicare | $242 |
| UnitedHealthcare | Medicare | $242 |
| Hawaii Western Management Group | Commercial | $256 |
| Hawaii Medical Service Association | Commercial | $263 |
| Hawaii Medical Service Association | ABD | $287 |
| Hawaii Medical Service Association | Non-ABD | $287 |
| UnitedHealthcare | Medicaid | $287 |
| Kaiser Permanente | Medicaid | $292 |
| Health Management Network | Commercial | $1,102 |
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