Upper GI endoscopy with biopsy at Mercy Hospital Perry RHC IV. CPT 43239.
What Mercy Hospital Perry RHC IV publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$628cash price (self-pay)
$837list price
$138–$712range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Medicaid Contracted [320430] | Pb Meridian IL Mcd Health Plan | $138 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Preferred/Pathways | $309 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Access | $325 |
| Mc Anthem [20455] | Pb Pcmh Blue Access | $325 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Traditional | $355 |
| Humana Medicare Advantage [20194] | Pb IL Humana Mcr-Mcd Dsnp | $403 |
| Humana Medicare Advantage Contracted [320194] | Pb IL Humana Mcr-Mcd D | $403 |
| Cigna Healthcare [20071] | Pb Pcmh Cigna Comm | $426 |
| Cigna Healthcare Contracted [320071] | Pb Pcmh Cigna Comm | $426 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $460 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $460 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $464 |
| Home State Health Plan Contracted [320187] | Pb Pcmh Ambetter Exchange | $476 |
| Centivo Contracted [320505] | Pb Pcmh Cape Stod Centivo | $506 |
| Medica [20239] | Pb Stl Medica | $567 |
| Medica Contracted [320239] | Pb Stl Medica | $567 |
| Hope Trust Contracted [320488] | Pb Stl Pcmh Dec Hope Trust | $709 |
| Aither Health Contracted [320449] | Pb Pcmh Dec Laclede Chain | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Dec Fcb Banks | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Buchheit Dec | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Dec Hydromat | $711 |
| Healthlink Contracted [320179] | Pb Pcmh Dec Carrollton | $711 |
| Imagine 360 Contracted [320494] | Pb Pcmh Dec Robinson Construction | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Easter Seals | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Quiktrip | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Town & Country Supermarket | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Clayco Dec | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec Bartel Communica | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec City Of Jackson | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec Easter Seals | $711 |
Inpatient
$628cash price (self-pay)
$837list price
$138–$712range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Medicaid Contracted [320430] | Pb Meridian IL Mcd Health Plan | $138 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Preferred/Pathways | $309 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Access | $325 |
| Mc Anthem [20455] | Pb Pcmh Blue Access | $325 |
| Blue Cross And Blue Shield [20053] | Pb Pcmh Blue Traditional | $355 |
| Humana Medicare Advantage [20194] | Pb IL Humana Mcr-Mcd Dsnp | $403 |
| Humana Medicare Advantage Contracted [320194] | Pb IL Humana Mcr-Mcd D | $403 |
| Cigna Healthcare [20071] | Pb Pcmh Cigna Comm | $426 |
| Cigna Healthcare Contracted [320071] | Pb Pcmh Cigna Comm | $426 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $460 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $460 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $464 |
| Home State Health Plan Contracted [320187] | Pb Pcmh Ambetter Exchange | $476 |
| Centivo Contracted [320505] | Pb Pcmh Cape Stod Centivo | $506 |
| Medica [20239] | Pb Stl Medica | $567 |
| Medica Contracted [320239] | Pb Stl Medica | $567 |
| Hope Trust Contracted [320488] | Pb Stl Pcmh Dec Hope Trust | $709 |
| Aither Health Contracted [320449] | Pb Pcmh Dec Laclede Chain | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Dec Fcb Banks | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Buchheit Dec | $711 |
| Auxiant Contracted [320462] | Pb Pcmh Dec Hydromat | $711 |
| Healthlink Contracted [320179] | Pb Pcmh Dec Carrollton | $711 |
| Imagine 360 Contracted [320494] | Pb Pcmh Dec Robinson Construction | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Easter Seals | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Quiktrip | $711 |
| Mercy Benefit Admin [20251] | Pb Pcmh Dec Town & Country Supermarket | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Clayco Dec | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec Bartel Communica | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec City Of Jackson | $711 |
| Mercy Benefit Admin Contracted [320251] | Pb Pcmh Dec Easter Seals | $711 |
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