Upper GI endoscopy with biopsy at Pennsylvania Hospital. CPT 43239.
What Pennsylvania Hospital publishes for this service, straight from its standard-charges file, last updated March 20, 2026.
Outpatient / ER
$4,273cash price (self-pay)
$4,273list price
$190–$20,526range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $190 |
| UPMC | UPMC Medicaid | $253 |
| PA Medical Assistance | Medicaid | $281 |
| Managed Medicaid Other | Managed Medicaid Other | $281 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $323 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $554 |
| Horizon NJ Health | Horizon NJ Health | $751 |
| TriCare | TriCare | $953 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $983 |
| UnitedHealthcare | UnitedHealthcare Compass Exchange | $994 |
| US Family Health Plan | US Family Health Plan | $1,096 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1,111 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $1,496 |
| Qualcare | Qualcare | $1,624 |
| Wissahickon Hospice | Wissahickon Hospice | $1,709 |
| Pgm - Chop | Pgm - Chop | $1,709 |
| Olympus | Olympus | $2,077 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $2,113 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $2,137 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $2,179 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $2,564 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $2,607 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $2,777 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $2,777 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $2,981 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $2,991 |
| IBC Commercial HPN | IBC Commercial HPN | $3,417 |
| Preferred Care | Preferred Care | $3,418 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $3,418 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $3,418 |
Inpatient
$4,273cash price (self-pay)
$4,273list price
$722–$4,273range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $722 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $983 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $1,111 |
| Devon | Devon Premier | $1,624 |
| Pgm - Chop | Pgm - Chop | $1,709 |
| Coventry | HealthAmerica/Coventry SEPA | $1,709 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $1,923 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $2,094 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $2,137 |
| First Health Global | First Health Global | $2,137 |
| Coventry | Coventry of Delaware | $2,179 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $2,564 |
| Health Net | Health Net | $2,564 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $2,777 |
| Preferred Care | Preferred Care | $3,418 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $3,418 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $3,418 |
| Intergroup | Intergroup | $3,418 |
| Humana Choice Care | Humana Choice Care | $3,418 |
| Health America/CCN | First Health/ Coventry National | $3,418 |
| Devon Health Services Inc | Devon Health Services | $3,418 |
| UPMC | UPMC Medicaid | $4,273 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $4,273 |
| United Behavioral Health | United Behavioral Health | $4,273 |
| Quest Behavioral Health | Quest Behavioral Health | $4,273 |
| Managed Medicaid Other | Managed Medicaid Other | $4,273 |
| International PFS | International PFS | $4,273 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $4,273 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $4,273 |
| Health Partners | Health Partners Medicaid | $4,273 |
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