Upper GI endoscopy with biopsy at Samaritan Hospital. CPT 43239.
What Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$301cash price (self-pay)
$301list price
$43.62–$9,047range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Capital District Physicians Health Medicaid Advantage | Cdphp Medicaid | $207 |
| Commonwealth Care Alliance | Pb Xr 100% Default | $301 |
| Dentaquest | Pb Xr 100% Default | $301 |
| Pace Of Southwest Michigan | Pb Xr 100% Default | $301 |
| Everence | Pb Xr 100% Default | $301 |
| Health Choices | Pb Xr 100% Default | $301 |
| Union Health Service | Pb Xr 100% Default | $301 |
| Molina Medicare Advantage | Pb Xr 100% Default | $301 |
| The Health Plan | Pb Xr 100% Default | $301 |
| Harvard Pilgrim Healthcare | Pb Xr 100% Default | $301 |
| Rx Allwin | Pb Xr 100% Default | $301 |
| Common Ground | Pb Xr 100% Default | $301 |
| Auxiant | Pb Xr 100% Default | $301 |
| Auto Owners | Pb Xr 100% Default | $301 |
| Wc Rev Claims | Pb Xr 100% Default | $301 |
| Amerigroup Medicaid | Pb Xr 100% Default | $301 |
| American National | Pb Xr 100% Default | $301 |
| Ameriben | Pb Xr 100% Default | $301 |
| Alta Health | Pb Xr 100% Default | $301 |
| Lasso Healthcare Msa | Pb Xr 100% Default | $301 |
| Pace Southeast | Pb Xr 100% Default | $301 |
| Blue Cross - Ky (Anthem) Medicare Advantage | Pb Xr 100% Default | $301 |
| Blue Cross - Ga (Anthem) Medicare Advantage | Pb Xr 100% Default | $301 |
| Upmc Medicare Advantage | Pb Xr 100% Default | $301 |
| Total Healthcare Medicare Snp | Pb Xr 100% Default | $301 |
| Hap Empowered Mi Health Link Medicare Dual | Pb Xr 100% Default | $301 |
| Blue Cross - NY (Anthem) Medicare Advantage | Pb Xr 100% Default | $301 |
| Blue Cross - Ne Medicare Advantage | Pb Xr 100% Default | $301 |
| Cca - Zing Health | Pb Xr 100% Default | $301 |
| Mercyone Cedar Valley | Pb Xr 100% Default | $301 |
Inpatient
$349cash price (self-pay)
$349list price
$43.67–$349range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicare Advantage | Pb Xr 100% Default | $349 |
| Rx Allwin | Pb Xr 100% Default | $349 |
| Commonwealth Care Alliance | Pb Xr 100% Default | $349 |
| Union Health Service | Pb Xr 100% Default | $349 |
| Health Choices | Pb Xr 100% Default | $349 |
| Dentaquest | Pb Xr 100% Default | $349 |
| Everence | Pb Xr 100% Default | $349 |
| The Health Plan | Pb Xr 100% Default | $349 |
| Harvard Pilgrim Healthcare | Pb Xr 100% Default | $349 |
| Pace Of Southwest Michigan | Pb Xr 100% Default | $349 |
| Ghc Scw | Pb Xr 100% Default | $349 |
| Blue Cross - IL Medicare Advantage | Pb Xr 100% Default | $349 |
| Blue Cross - Wi (Anthem) Medicare Advantage | Pb Xr 100% Default | $349 |
| Employee Benefits Systems | Pb Xr 100% Default | $349 |
| Phoenix Medicare Advantage | Pb Xr 100% Default | $349 |
| Consociate | Pb Xr 100% Default | $349 |
| Cigna Medicare Advantage | Pb Xr 100% Default | $349 |
| Claimsbridge | Pb Xr 100% Default | $349 |
| Coventry Medicare Advantage | Pb Xr 100% Default | $349 |
| Blue Cross - Mi Medicare Advantage | Pb Xr 100% Default | $349 |
| Country Life Ins | Pb Xr 100% Default | $349 |
| Allwell Medicare Advantage | Pb Xr 100% Default | $349 |
| American Postal Workers Secondary | Pb Xr 100% Default | $349 |
| Advantra Freedom Medicare Advantage | Pb Xr 100% Default | $349 |
| Pekin | Pb Xr 100% Default | $349 |
| Dean Health Medicare Select | Pb Xr 100% Default | $349 |
| Humana Medicare Advantage | Pb Xr 100% Default | $349 |
| Rx Aquinata Marywood | Pb Xr 100% Default | $349 |
| Rx Lipc/Mchp Copay | Pb Xr 100% Default | $349 |
| Healthfirst Medicare Advantage | Pb Xr 100% Default | $349 |
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