Upper GI endoscopy with biopsy at Dupont Hospital. CPT 43239.
What Dupont Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$88.83cash price (self-pay)
$657list price
$88.83–$10,063range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amish Aid | Amish Aid | $177 |
| Self Pay | Self Pay | $177 |
| Lutheran Preferred | Lutheran Preferred CHS Employees | $195 |
| Cigna | Cigna HMO | $212 |
| Cigna | Cigna PPO | $238 |
| Aetna | Aetna NBD | $243 |
| Aetna PSSD J and J | Aetna PSSD JJ | $243 |
| Physicians Health Plan | PHP Platinum Network | $254 |
| Lutheran Preferred | Lutheran Preferred Three Rivers Plus | $263 |
| Aetna | Aetna | $294 |
| Lutheran Preferred | Lutheran Preferred Fixed | $296 |
| Lutheran Preferred | Lutheran Preferred Inclusive | $296 |
| Lutheran Preferred | Lutheran Preferred Three Rivers | $296 |
| Encore PPO | Encore Combined PPO | $329 |
| Lutheran Preferred | Lutheran Preferred Exclusive Plus | $329 |
| Lutheran Network | Lutheran Preferred Exclusive Plus MRM | $329 |
| Veterans Eval Services | Veterans Eval Services | $331 |
| Medical Mutual of OH | Medical Mutual of Ohio | $348 |
| Sagamore | Sagamore Select Fully Insured | $353 |
| Lutheran Preferred | Lutheran Preferred Choice | $361 |
| Lutheran Preferred | Lutheran Preferred Exclusive | $361 |
| Sagamore | Sagamore Plus | $366 |
| Sagamore | Sagamore Select Self Insured | $366 |
| Lutheran Preferred | Lutheran Preferred CCSI | $394 |
| Prime Health Services | Prime Health Services | $493 |
| Prime Health Services | Prime Health Services Auto | $493 |
| FrontPath | FrontPath Health Coalition | $526 |
| Encore Health Network | Encore Fully Funded | $539 |
| Advantage Health Solutions | Advantage Health Solutions | $545 |
| Multiplan | Multiplan PPO Primary Network | $565 |
Inpatient
$148cash price (self-pay)
$657list price
$97.71–$591range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lutheran Preferred | Lutheran Preferred CHS Employees | $195 |
| Cigna | Cigna HMO | $212 |
| Cigna | Cigna PPO | $238 |
| Aetna | Aetna NBD | $243 |
| Aetna PSSD J and J | Aetna PSSD JJ | $243 |
| Physicians Health Plan | PHP Platinum Network | $254 |
| Aetna | Aetna | $294 |
| Self Pay | Self Pay | $296 |
| Medical Mutual of OH | Medical Mutual of Ohio | $348 |
| Lutheran Preferred | Lutheran Preferred Choice | $361 |
| Lutheran Preferred | Lutheran Preferred Exclusive | $361 |
| Lutheran Preferred | Lutheran Preferred CCSI | $394 |
| Prime Health Services | Prime Health Services | $493 |
| Prime Health Services | Prime Health Services Auto | $493 |
| FrontPath | FrontPath Health Coalition | $526 |
| Encore Health Network | Encore Fully Funded | $539 |
| Advantage Health Solutions | Advantage Health Solutions | $545 |
| Multiplan | Multiplan PPO Primary Network | $565 |
| Allied Benefit Systems | Allied Benefit Systems | $591 |
| Encore Health Network | Encore Self Funded | $591 |
| Multiplan | Multiplan PPO Complimentary Network | $591 |
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