Upper GI endoscopy with biopsy at Legacy Good Samaritan Medical Center IP Rehab. CPT 43239.
What Legacy Good Samaritan Medical Center IP Rehab publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$671cash price (self-pay)
$1,032list price
$1,008–$7,569range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $1,008 |
| Atrio | Medicare Managed Care Plan | $1,038 |
| Aetna | Medicare Managed Care Plan | $1,059 |
| HealthNet | Medicare Managed Care Plan | $1,069 |
| CareOregon | Medicare Managed Care Plan | $1,089 |
| Ageright | Medicare Managed Care Plan | $1,109 |
| Moda | Medicare Managed Care Plan | $1,129 |
| Kaiser | PEBB Other Commercial Plan | $2,016 |
| BCBS | Regence - Legacy LHP All Commercial Plans | $2,215 |
| BCBS | Regence - Blue HPN All Commercial Plans | $3,101 |
| BCBS | Regence All Commercial Plans | $3,247 |
| Moda | All Commercial Plans | $3,899 |
| HealthNet | All Commercial Plans | $4,275 |
| Cigna | LocalPlus All Commercial Plans | $5,288 |
| Aetna | All Commercial Plans | $6,073 |
| Cigna | All Commercial Plans | $6,796 |
| UnitedHealthCare | All Commercial Plans | $7,385 |
| First Health | All Commercial Plans | $7,569 |
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All common services at Legacy Good Samaritan Medical Center IP Rehab