Upper GI endoscopy with biopsy at Henry Ford River District Hospital. CPT 43239.
What Henry Ford River District Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$392–$1,745range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Health Plan | 1945_medicaid Replacement Meridian Health Outpa | $392 |
| Ppom | 934_ppom 20191001 | $409 |
| Tricare | 2211_tricare Op 20250101 | $919 |
| Meridian Wellcare | 2210_medicare Advantage Meridian Wellcare Outpatie | $965 |
| Phcs PPO Great West & Mailhandlers | 1458_phcs PPO Gr West & Mailhandl | $1,186 |
| Phcs POS | 1311_phcs POS 20201001 | $1,243 |
| Phcs PPO | 1457_phcs PPO 20201001 | $1,381 |
Inpatient
—cash price (self-pay)
—list price
$873–$1,745range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Pace | 2278_sjmc Sjma Pace Medicare Inpatient 20251001 | $873 |
| Amerihealth Vip Care | 2273_medicare Advantage Amerihealth Vip Care In | $909 |
| Aetna Better Health | 2272_medicare Advantage Aetna Better Health Inpa | $919 |
| Great Lakes Health Plan | 1960_sjrd Medicaid Replacement Great Lakes I | $919 |
| Harbor Advantage HMO | 2274_medicare Advantage Harbor Advantage HMO In | $919 |
| Medicare Replacement | 2279_medicare Advantage Blue Cross Network Conn | $919 |
| Tricare | 480_tricare Ip 20170101 | $919 |
| Veterans Choice | 2283_veterans Choice Ip 20251001 | $919 |
| Humana Mcr | 2275_medicare Advantage Humana Inpatient 20251001 | $928 |
| Total Health Care | 1965_sjrd Medicaid Replacement Total Health Care I | $928 |
| Mclaren Medicare Advantage HMO | 2276_medicare Advantage Mclaren Inpat | $965 |
| Meridian Wellcare | 2280_medicare Advantage Meridian Wellcare Inpatien | $965 |
| Molina Advantage | 2281_medicare Advantage Molina Inpatient 20251001 | $965 |
| Molina Health Link | 2282_medicare Advantage Molina Health Link Inpati | $965 |
| Meridian Ambetter | 2286_medicare Advantage Meridian Ambetter Inpatien | $1,148 |
| Molina Market Place | 2287_molina Marketplace Inpatient 20251001 | $1,148 |
| Smarthealth | 2284_smarthealth Inpatient 20251001 | $1,286 |
| Aaa-Auto Insurance | 2285_aaa-Auto Insurance Inpatient 20251001 | $1,745 |
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