Upper GI endoscopy with biopsy at Jones Memorial Hospital. CPT 43239.
What Jones Memorial Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$345cash price (self-pay)
$2,072list price
$84.00–$2,965range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Highmark Blue Cross Blue Shield Medicaid 1702 | Highmark BCBS Medicaid | $121 |
| Excellus Medicaid 1706, Excellus Blue Cross Blue Shield 2201 | Blue Ch | $136 |
| Mvp Medicaid 1712, Mvp 2900 | Mvp Option Medicaid 171201, Mvp Essentia | $188 |
| Excellus Medicaid 1706, Excellus Blue Cross Blue Shield 2201 | Univera | $197 |
| Umr 5142, Pomco Ins Co 5157, United Healthcare 5158 | Umr 514201, Pomc | $227 |
| Aetna Medicare 1300, Aetna 2700 | Aetna Medicare 130001, Aetna Senior | $229 |
| Medicare Blue Choice 1306 | Medicare Blue Choice 130601, Blue Medicare | $229 |
| United Healthcare Medicare 1309 | United Healthcare Medicare 130901, S | $230 |
| Mvp 2900 | Mvp Premier Individual 290002, Mvp Premier Group 290003 | $230 |
| Mvp Medicare 1307, Mvp Medicare Dual Access Dsnp 1321 | Mvp Medicare 1 | $231 |
| Capital District Physicians (Cdphp) Medicaid 1704 | Capital District P | $233 |
| Medicare Blue Choice 1306 | Univera Senior Choice Medicare 130603 | $234 |
| Molina Medicaid 1723, Molina Healthcare 5189 | Molina Medicaid 172301, | $238 |
| Empire Plan 5179, Empire Plan UHC 5180 | Empire Plan 517901, Empire Pl | $243 |
| United Healthcare Medicare 1309 | United Healthcare Dual Complete 1309 | $245 |
| Fidelis Medicaid 1708, Fidelis 5155 | Fidelis Medicaid 170801, Fidelis | $245 |
| Fidelis Medicaid 1708, Fidelis 5155 | Fidelis Essential (W/ Medicaid) | $257 |
| Mvp 2900, Cigna 5144 | Mvp Commercial Non PPO Fully Insured 290001, Mv | $318 |
| Lifetime Benefit Solutions 2200, Excellus Blue Cross Blue Shield 2201, | $320 |
| Fidelis 5155 | Fidelis Metal Tiers 515501 | $331 |
| Independent Health 5156 | Independent Health (Buffalo NY) 515601, Nova | $339 |
| Excellus Blue Cross Blue Shield 2201 | Univera 220104 | $350 |
| Excellus Blue Cross Blue Shield 2201 | Excellus Metal Tiers 220102, Un | $404 |
| Cdphp Medicare 1320 | Cdphp Medicare 132001 | $408 |
| Capital District Physicians Health Plan (Cdphp) 5149 | Capital Distric | $631 |
| Upmc Health Plan 5138 | Upmc Health Plan 513801 | $909 |
| United Healthcare 5158 | United Healthcare 515803 | $1,198 |
| Excellus Blue Cross Blue Shield 2201, Out Area Blue Cross Blue Shield, | $1,213 |
| Humana Medicare 1312 | Humana Medicare 131201 | $1,213 |
| United Healthcare Medicare 1309 | United Healthcare Medicare 130901 | $1,213 |
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