Upper GI endoscopy with biopsy at Davis County Hospital. CPT 43239.
What Davis County Hospital publishes for this service, straight from its standard-charges file, last updated July 24, 2026.
Outpatient / ER
$853cash price (self-pay)
$853list price
$115–$879range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Home State Hlth Exch - All Other Plans | Home State Hlth Exch - All Ot | $115 |
| Aetna Mcr Adv-All Plans | Aetna Mcr Adv-All Plans | $115 |
| Choicecare Mcr Adv | Choicecare Mcr Adv | $115 |
| Home State Hlth Mcr | Home State Hlth Mcr | $115 |
| Tricare-All Plans | Tricare-All Plans | $115 |
| Amerigroup Mcr Adv-All Other Plans | Amerigroup Mcr Adv-All Other Plan | $117 |
| Mt Carmel Hp-All Plans | Mt Carmel Hp-All Plans | $121 |
| American Hp Mcr Adv-All Plans | American Hp Mcr Adv-All Plans | $121 |
| Choicecare Comm - All Other Plans | Choicecare Comm - All Other Plans | $173 |
| Preferred Hlth Choices - All Plans | Preferred Hlth Choices - All Plan | $219 |
| Wellmark BCBS HMO | Wellmark BCBS HMO | $263 |
| Midlands Choice - All Plans | Midlands Choice - All Plans | $307 |
| Wellmark BCBS PPO - All Other Plans | Wellmark BCBS PPO - All Other Pl | $309 |
| Home State Hlth Mcaid | Home State Hlth Mcaid | $853 |
| Iowa Total Care Mcaid-All Plans | Iowa Total Care Mcaid-All Plans | $870 |
| Molina Mcaid-All Plans | Molina Mcaid-All Plans | $874 |
| Amerigroup Mcaid | Amerigroup Mcaid | $879 |
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