Upper GI endoscopy with biopsy at Good Samaritan Hospital (GSH). CPT 43239.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$116–$2,274range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Direct Health | Direct Health | $116 |
| OneCare | Commercial | $203 |
| Aetna | Commercial | $277 |
| HealthLink | HMO | $488 |
| HealthLink | PPO | $514 |
| Aetna | Medicare Advantage | $538 |
| Allwell | MCR ADV/PPO/HMO | $538 |
| Anthem MCR | MCR ADV/PPO/HMO | $538 |
| Anthem MCR | Medicare Advantage | $538 |
| Anthem | MCR ADV/PPO/HMO | $538 |
| Cigna | Medicare Advantage | $538 |
| Humana | Medicare Advantage | $538 |
| United Healthcare | Medicare Advantage | $538 |
| Encore Prime | Commercial | $561 |
| Anthem | HealthSync | $575 |
| Alliance Coal | Commercial | $778 |
| CareSource | Commercial | $792 |
| Indiana University | MCR ADV/PPO/HMO | $960 |
| MHS Ambetter | Commercial | $960 |
| Meridian | Medicare Advantage | $960 |
| Molina | Medicaid | $960 |
| Molina | Medicare Advantage | $960 |
| Optum | MCR ADV/PPO/HMO | $960 |
| Hope Trust | Commercial | $1,076 |
| Anthem HIP | HIP | $1,195 |
| BCBS | Medicare Advantage | $1,195 |
| Anthem | Medicaid | $1,199 |
| Caresource HIP | Medicaid | $1,199 |
| Caresource | Medicaid | $1,199 |
| Anthem | Trad/PPO/HMO | $1,244 |
Inpatient
—cash price (self-pay)
—list price
$331–$780range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $331 |
| Caresource HIP | Medicaid | $331 |
| Caresource | Medicaid | $331 |
| Anthem | Trad/PPO/HMO | $366 |
| Aetna | Medicare Advantage | $390 |
| Alliance Coal | Commercial | $390 |
| Anthem HIP | HIP | $390 |
| Anthem MCR | MCR ADV/PPO/HMO | $390 |
| Anthem MCR | Medicare Advantage | $390 |
| Anthem | MCR ADV/PPO/HMO | $390 |
| BCBS | Medicare Advantage | $390 |
| Cigna | Medicare Advantage | $390 |
| Humana | Medicare Advantage | $390 |
| United Healthcare | Medicare Advantage | $390 |
| Allwell | MCR ADV/PPO/HMO | $390 |
| Direct Health | Direct Health | $390 |
| CareSource | Commercial | $487 |
| Aetna | Commercial | $585 |
| OneCare | Commercial | $682 |
| Hope Trust | Commercial | $780 |
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