Upper GI endoscopy with biopsy at Chelsea Hospital. CPT 43239.
What Chelsea Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$5,019cash price (self-pay)
—list price
$95.32–$4,318range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | Molina Medicaid | $118 |
| Medicaid - Ut | Medicaid | $118 |
| Medicaid - TX | Medicaid | $118 |
| Medicaid - Tn | Medicaid | $118 |
| Medicaid - Va | Medicaid | $118 |
| Medicaid - Vt | Medicaid | $118 |
| Buckeye Health Plan Medicaid Advantage | Medicaid | $118 |
| Wellpoint Medicaid | Medicaid | $118 |
| Managed Health Services - Indiana | Medicaid | $118 |
| Amerihealth Caritas Medicaid | Medicaid | $118 |
| Unity Medicaid | Medicaid | $118 |
| Ucare Medicaid | Medicaid | $118 |
| Kern Family Health Plan | Medicaid | $118 |
| Inland Empire Health Plan | Medicaid | $118 |
| Community Care Behavorial Health | Medicaid | $118 |
| California Health And Wellness | Medicaid | $118 |
| Blue Plus Mo Medicaid | Medicaid | $118 |
| Medicaid - Ks | Medicaid | $118 |
| Mclaren Health Medicaid | Mclaren Medicaid | $123 |
| Veterans Eval Services | Tricare | $177 |
| Rx Allwin | Medicare | $203 |
| Hap Medicare Advantage | Hap Medicare Advantage | $203 |
| Priority Health Medicare Advantage | Priority Health Medicare Advantag | $203 |
| Blue Care Network Advantage | Bcn Medicare Advantage | $203 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $203 |
| Blue Cross - Mi Medicare Advantage | BCBS Medicare Advantage | $203 |
| Molina Medicare Advantage | Molina Medicare Advantage | $203 |
| Medicare Alternate Payor | Medicare | $203 |
| Meridian Complete | Medicare | $203 |
| Peak Pace Solutions | Medicare | $203 |
Inpatient
—cash price (self-pay)
$301list price
$43.67–$261range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Vt | Medicaid | $43.67 |
| Medicaid - Sd | Medicaid | $43.67 |
| Medicaid - Tn | Medicaid | $43.67 |
| Medicaid - Pa | Medicaid | $43.67 |
| Medicaid - Ri | Medicaid | $43.67 |
| Medicaid - Sc | Medicaid | $43.67 |
| Medicaid - Oh | Medicaid | $43.67 |
| Medicaid - Ok | Medicaid | $43.67 |
| Philadelphia County Funding | Medicaid | $43.67 |
| Medicaid - Or | Medicaid | $53.50 |
| Rx Allwin | Medicare | $62.96 |
| Clover Health | Medicare | $62.96 |
| Champion Health Plan Mcr Advantage | Medicare | $62.96 |
| Aetna Medicare Assure Premier HMO D-Snp | Medicare | $62.96 |
| Hudson Headwaters Pace | Medicare | $62.96 |
| American Health Advantage Of Idaho | Medicare | $62.96 |
| Sanford Health Plan Medicare Advantage | Medicare | $62.96 |
| Serenity Pace | Medicare | $62.96 |
| Solis Health Plans | Medicare | $62.96 |
| Fresno Pace Medicare | Medicare | $62.96 |
| American Health Plan | Medicare | $62.96 |
| Iowa Health Advantage | Medicare | $62.96 |
| Provider Partners Health Plan Of Indiana | Medicare | $62.96 |
| Gold Kidney Medicare | Medicare | $62.96 |
| Siouxland Pace | Medicare | $62.96 |
| Mercy Life | Medicare | $62.96 |
| Wc Advantage | Cofinity Workers Comp | $97.61 |
| Muskegon County Jail | Vitalcore Health | $99.57 |
| Wc Medical Administrators | Workers Comp | $103 |
| Wc Hab | Workers Comp | $103 |
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