Upper GI endoscopy with biopsy at UPMC Lititz. CPT 43239.
What UPMC Lititz publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$2,020cash price (self-pay)
$3,366list price
$189–$5,035range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $189 |
| UPMC Health Plan | Managed Medicaid | $193 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $195 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $202 |
| Geisinger | Medicaid/CHIP | $216 |
| United Healthcare Community Plan for Families | PA Medicaid | $368 |
| Prime Net | Managed Medicare | $633 |
| Capital Blue Cross | Medicare Advantage | $673 |
| Keystone Health Plan | Medicare Advantage | $673 |
| UPMC Work Partners | Workers Comp | $764 |
| Highmark BCBS of PA | Medicare | $891 |
| Aetna | Medicare | $939 |
| Cigna | Medicare | $946 |
| Geisinger | Medicare | $946 |
| United Healthcare | Medicare | $964 |
| Prime Net | Legacy Commercial | $1,313 |
| Aetna | ACO | $1,323 |
| Prime Net | ACO | $1,323 |
| Keystone Autism Services | ACAP | $1,441 |
| Prime Net | NonGateKeeper | $1,565 |
| Aetna | Commercial | $1,575 |
| Prime Net | GateKeeper | $1,575 |
| Capital Blue Cross | CHIP | $1,579 |
| Capital Blue Cross | Commercial | $1,579 |
| Keystone Health Plan | Commercial | $1,579 |
| Preferred Healthcare System | Inter County Health Plan/Lancaster Gener | $1,851 |
| Geisinger | Commercial | $2,204 |
| UPMC Health Plan | CHIP | $2,317 |
| UPMC Health Plan | Commercial | $2,356 |
| Prime Net | FH-Medical Rental | $2,437 |
Inpatient
$2,020cash price (self-pay)
$3,366list price
$1,249–$2,861range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Prime Net | Legacy Commercial | $1,249 |
| Aetna | ACO | $1,259 |
| Prime Net | ACO | $1,259 |
| Prime Net | NonGateKeeper | $1,488 |
| Aetna | Commercial | $1,498 |
| Prime Net | GateKeeper | $1,498 |
| Preferred Healthcare System | Inter County Health Plan/Lancaster Gener | $1,851 |
| Geisinger | Commercial | $2,431 |
| Prime Net | FH-Medical Rental | $2,437 |
| Preferred Healthcare System | PPO | $2,525 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,861 |
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