Upper GI endoscopy with biopsy at Saint Alphonsus Medical Center-Ontario. CPT 43239.
What Saint Alphonsus Medical Center-Ontario publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$446cash price (self-pay)
—list price
$95.32–$449range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Allwin | Medicare | $203 |
| Blue Cross - IL Medicare Advantage | Medicare | $203 |
| Blue Cross - Mn Medicare Advantage | Medicare | $203 |
| Medicare | Medicare | $203 |
| Cigna Medicare Advantage | Medicare | $203 |
| Blue Cross - Ct (Anthem) Medicare Advantage | Medicare | $203 |
| Osu Prime Care Advantage | Medicare | $203 |
| Phoenix Medicare Advantage | Medicare | $203 |
| Blue Cross - Wi (Anthem) Medicare Advantage | Medicare | $203 |
| Carecentrix Medicare Advantage | Medicare | $203 |
| Allwell Medicare Advantage | Medicare | $203 |
| The Health Plan | Medicare | $203 |
| Medical Mutual Medicare | Medicare | $203 |
| Hap Medicare Advantage | Medicare | $203 |
| Care Wisconsin Medicare | Medicare | $203 |
| Blue Cross - Ia (Wellmark) Medicare Advantage | Medicare | $203 |
| Blue Cross - Mi Medicare Advantage | Medicare | $203 |
| Coventry Medicare Advantage | Medicare | $203 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $218 |
| South Country Health Alliance Medicaid | Medicaid | $221 |
| Maryland Healthy Smiles - Scion Dental | Medicaid | $221 |
| Healthy Blue Ne | Medicaid | $221 |
| California Health And Wellness | Medicaid | $221 |
| Blue Plus Mo Medicaid | Medicaid | $221 |
| Iowa Total Care | Medicaid | $221 |
| Commonwealth Care Alliance Medicaid | Medicaid | $221 |
| Community Care Behavorial Health | Medicaid | $221 |
| Mo Home State Health Plan | Medicaid | $221 |
| Healthy Blue Plus Mo Medicaid | Medicaid | $221 |
| Geisinger Medicaid Advantage | Medicaid | $221 |
Inpatient
$554cash price (self-pay)
$554list price
$39.41–$228range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Allwin | Medicare | $59.17 |
| Blue Cross - Ms Medicare Advantage | Medicare | $59.17 |
| Elementcare | Medicare | $59.17 |
| Blue Cross - NY (Excellus) Medicare Advantage | Medicare | $59.17 |
| Tribute Health Plans | Medicare | $59.17 |
| Fidelis Medicare | Medicare | $59.17 |
| Union Health Service | Medicare | $59.17 |
| Sanford Health Plan Medicare Advantage | Medicare | $59.17 |
| Nascentia Health Plus | Medicare | $59.17 |
| Central Health Medicare Advantage | Medicare | $59.17 |
| Tristate Benefit Solutions Medicare Advantage | Medicare | $59.17 |
| Tufts Medicare Advantage | Medicare | $59.17 |
| Carefirst Medicare Advantage | Medicare | $59.17 |
| Keystone First Chc Medicare Advantage | Medicare | $59.17 |
| Gateway Health Plan | Medicare | $59.17 |
| Blue Cross - Oh (Anthem) Medicare Advantage | Medicare | $59.17 |
| Mclaren Health Medicare Advantage | Medicare | $59.17 |
| Blue Cross - Ct (Anthem) Medicare Advantage | Medicare | $59.17 |
| Blue Cross - Ri Medicare Advantage | Medicare | $59.17 |
| Vnsny Choice Medicare | Medicare | $59.17 |
| Horizon Nj Total Care | Medicare | $59.17 |
| Blue Cross - Or (Regence) Medicare Advantage | Regence BCBS Medicare A | $63.40 |
| Tricare East Humana | Tricare | $64.32 |
| Cmh Newaygo County | Medicaid | $80.25 |
| Medi-Cal | Medicaid | $80.25 |
| Medi-Cal Healthnet | Medicaid | $80.25 |
| Peach State Healthplan | Medicaid | $80.25 |
| Cmh Genesee County | Medicaid | $80.25 |
| Cmh Barry County | Medicaid | $80.25 |
| Cmh Bay-Arenac County | Medicaid | $80.25 |
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All common services at Saint Alphonsus Medical Center-Ontario