Upper GI endoscopy with biopsy at Roxborough Memorial Hospital. CPT 43239.
What Roxborough Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$927cash price (self-pay)
$5,569list price
$158–$6,638range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Traditional Medicaid | Traditional Medicaid | $281 |
| Humana Military Tricare | Humana Military Tricare | $742 |
| UHC | UHC Va Ccn | $927 |
| Health Partners Plan | Health Partners Plan Medicare | $927 |
| Independence Blue Cross | IBC Medicare | $927 |
| PA Health & Wellness | PA Health & Wellness Medicare & Duals | $927 |
| Traditional Medicare | Traditional Medicare | $927 |
| Tricare | Tricare | $927 |
| UHC | UHC Medicare | $927 |
| Providers Partner Health Plan | Provider Partners Health Plan | $955 |
| Keystone | Keystone First Medicare | $964 |
| Ally-Align Medicare | Ally-Align Medicare | $974 |
| Spartan | Spartan Plan | $974 |
| Auto Insurance | Auto Insurance | $1,020 |
| Worker Compensation | Worker Compensation | $1,048 |
| PA Health & Wellness | PA Health & Wellness Commercial Insurance Excha | $1,113 |
| Employer Direct Healthcare | Employer Direct Healthcare | $1,298 |
| Health Partners Plan | Health Partners Plan Exchange | $1,391 |
| Naphcare | Naphcare | $1,437 |
| UHC | UHC Exchange | $1,459 |
| Health Partners Plan | Health Partners Plan Medicaid | $1,582 |
| Keystone | Keystone First Medicaid | $1,896 |
| UHC | UHC Commercial All Payer | $1,938 |
| Independence Blue Cross | IBC PPACA | $1,999 |
| Highmark | Highmark Commercial (02-01-2024 to 12-31-2026) | $2,020 |
| UHC | UHC Medicaid | $2,040 |
| Cigna | Cigna Commercial (05-01-2023 to 12-31-2026) | $2,193 |
| Independence Blue Cross | IBC Indemnity | $2,523 |
| Independence Blue Cross | IBC Commercial HMO PPO | $2,523 |
| PA Health & Wellness | PA Health & Wellness Medicaid | $3,500 |
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