Upper GI endoscopy with biopsy at Good Samaritan University Hospital. CPT 43239.
What Good Samaritan University Hospital publishes for this service, straight from its standard-charges file, last updated February 19, 2026.
Outpatient / ER
—cash price (self-pay)
$3,435list price
$286–$4,731range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Affinity Health Plan | CHP | $1,040 |
| Affinity Health Plan | HARP | $1,040 |
| Affinity Health Plan | MEDICAID | $1,040 |
| Centerlight Healthcare | MEDICAID | $1,040 |
| BCBS-NY Empire | MA | $1,087 |
| Aetna | Medicare | $1,109 |
| Centerlight Healthcare | PACE | $1,109 |
| Centers Plan For Healthy Living | Medicare | $1,109 |
| Agewell New York | Medicare HMO | $1,148 |
| Brighton | Create IDN | $1,200 |
| Brighton | Create Flex | $1,234 |
| Allied Wellfare Fund | Commercial | $2,233 |
| American Group Administrators | Commercial | $2,233 |
| Bakery & Confectionery Union | Commercial | $2,233 |
| Cigna | Indemnity | $2,233 |
| Comprehensive Benefits Consultant | Commercial | $2,233 |
| Affinity Health Plan | EP 1&2 | $2,341 |
| Affinity Health Plan | EP 3&4 | $2,341 |
| Coventry | HMO | $2,542 |
| Coventry | First Health PPO | $2,920 |
| BCBS-NY Empire | Blue Access Small Group | $3,013 |
| Brighton | LOCAL 3 MAGNA JIB | $3,083 |
| Aither Health | Commercial | $3,435 |
| Alpha Care | Medicare FIDA | $3,435 |
| Dentaquest | Affinity MCD | $3,435 |
| Dentaquest | HealthFirst MCD | $3,435 |
| Brighton | Direct Plus | $3,547 |
| Brighton | PPO | $3,547 |
| BCBS-NY Empire | Blue Access Large Group | $3,568 |
| Centivo | Commercial | $3,685 |
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