Upper GI endoscopy with biopsy at Jacksonville Memorial Hospital. CPT 43239.
What Jacksonville Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$1,900cash price (self-pay)
$1,900list price
$7.99–$1,963range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| WellCare Medicare Advantage PPO | WellCare Medicare Advantage PPO | $299 |
| UHC Va Ccn | UHC Va Ccn | $304 |
| Blue Cross Blue Shield | Blue Cross Community MMAI/Dual Eligible | $323 |
| Tricare | Tricare | $342 |
| Coventry | Coventry Advantra Medicare Advantage HMO | $344 |
| Health Alliance | Health Alliance Medicare Advantage | $344 |
| Humana | Humana/ChoiceCare Medicare Advantage PPO/HMO | $344 |
| Medicare | Medicare | $344 |
| United HealthCare | United HealthCare Medicare Advantage | $361 |
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $874 |
| Commercial Workers Compensation | Commercial Workers Compensation | $936 |
| 6 Degrees Health | 6 Degrees Health | $1,140 |
| Hope Trust | Hope Trust | $1,140 |
| Hst | Hst | $1,140 |
| Corvel/CorCare | Corvel/CorCare | $1,151 |
| Health Alliance | Health Alliance Fully Insured/Self Funded/ACA | $1,164 |
| Cigna | Cigna | $1,317 |
| United Healthcare | United Healthcare PPO | $1,368 |
| Illinois Workers Compensation | Illinois Workers Compensation | $1,381 |
| Aetna | Aetna PPO | $1,424 |
| Current Health Network | Current Health Network | $1,425 |
| Healthlink | Healthlink HMO | $1,568 |
| Humana/ChoiceCare | Humana/ChoiceCare | $1,621 |
| PHCS/Multiplan | PHCS/Multiplan PPO | $1,710 |
| Hfn | Hfn PPO | $1,805 |
| HFN | HFN Workers Compensation | $1,805 |
| Medicaid | Illinois Medicaid | $1,889 |
| Molina HealthCare | Molina Medicaid | $1,889 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $1,900 |
| Liability | Liability | $1,900 |
Inpatient
$1,900cash price (self-pay)
$1,900list price
$874–$1,900range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $874 |
| Current Health Network | Current Health Network | $1,045 |
| 6 Degrees Health | 6 Degrees Health | $1,140 |
| Hope Trust | Hope Trust | $1,140 |
| Hst | Hst | $1,140 |
| Cigna | Cigna | $1,317 |
| Aetna | Aetna PPO | $1,328 |
| Humana/ChoiceCare | Humana/ChoiceCare | $1,621 |
| Hfn | Hfn PPO | $1,805 |
| HFN | HFN Workers Compensation | $1,805 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $1,900 |
| Liability | Liability | $1,900 |
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