Upper GI endoscopy with biopsy at Mercy Hospital Boonville. CPT 43239.
What Mercy Hospital Boonville publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$623cash price (self-pay)
$7,210list price
$5.00–$1,689range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare [20244] | Hb Bnvar Medicare | $130 |
| Medicaid [20240] | Hb Bnvar Ark Medicaid | $184 |
| Empower Healthcare Solutions Medicaid Contracted [320118] | Hb Bnvar P | $234 |
| Empower Healthcare Solutions Medicaid [20118] | Hb Bnvar Passe Empower | $234 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Bnv | $282 |
| Nhc Advantage Medicare Contracted [320282] | Hb Bnvar Managed Medicare | $282 |
| Humana Medicare Advantage Contracted [320194] | Hb Bnvar Humana Mcr | $282 |
| Humana Medicare Advantage Contracted [320194] | Hb Bnvar Managed Medic | $282 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Bnvar Managed | $282 |
| United Behavioral Health Medicare Advantage Contracted [320392] | Hb B | $282 |
| Qual Choice Contracted [320325] | Hb Bnvar Managed Medicare | $282 |
| Tricare Contracted [320380] | Hb Bnvar Tricare | $283 |
| Wellcare Medicare Advantage Contracted [320421] | Hb Bnvar Novasys Mcr | $290 |
| Summit Community Care [20368] | Hb Bnvar Ark Medicaid | $363 |
| Summit Community Care Contracted [320368] | Hb Bnvar Summit | $363 |
| Caresource Medicaid [20460] | Hb Bnvar Caresource Medicaid | $370 |
| Caresource Medicaid Contracted [320460] | Hb Bnvar Caresource Medicaid | $370 |
| Centivo Contracted [320505] | Hb Bnvar Centivo Mcr | $465 |
| Mercy Benefit Admin Contracted [320251] | Hb Ftsm Dec Quiktrip Co | $575 |
| Mc Anthem [20455] | Hb Bnvar Blue Cross | $683 |
| Blue Cross And Blue Shield [20053] | Hb Bnvar Blue Cross | $683 |
| Usable Contracted [320409] | Hb Bnvar Blue Cross | $683 |
| Private Health Care Systems Contracted [320320] | Hb Bnvar Multiplan | $766 |
| Multiplan Contracted [320270] | Hb Bnvar Multiplan | $766 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar,B | $814 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar D | $814 |
| Yuzu Health Contracted [320521] | Hb Wldar,Ozkar,Prsar,Bnvar, Bryvl De | $814 |
| Edison Health Solutions Contracted [320502] | Hb Wldar,Ozkar,Prsar,Bnv | $814 |
| Imagine 360 Contracted [320494] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv Dec | $814 |
| Reflect Health Contracted [320492] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv D | $814 |
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