Upper GI endoscopy with biopsy at Le Bonheur Children's Hospital. CPT 43239.
What Le Bonheur Children's Hospital publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$988cash price (self-pay)
$7,747list price
$134–$8,293range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ar - Medicaid [300005] | Hb Medicaid-Ar Contract | $297 |
| Ar Medicaid Replacement [350010] | Hb Xr Ar Passe Caid/Caresource/Empo | $297 |
| Molina Healthcare [350012] | Hb Molina Hc Of Ms - Mscan Mlh-Tn Contrac | $672 |
| MS MEDICAID TrueCare [350022] | HB MEDICAID MS - TN Locations | $672 |
| MS - MEDICAID [300025] | HB MEDICAID MS - TN Locations | $672 |
| MS - MEDICAID [300025] | HB MEDICAID MS - MAGNOLIA HEALTHCARE - TN Loc | $672 |
| Ms - Medicaid [300025] | Hb Molina Hc Of Ms - Mscan Mlh-Tn Contract | $672 |
| UHC Medicaid [350006] | Hb UHC Ms Can Mlh-Tn-Leb Contract | $672 |
| Wellpoint Medicaid [350002] | Hb Amerigroup-Wellpoint Lebonheur Cont | $688 |
| Tricare [600001] | Hb Tricare - Tn Contract | $811 |
| Molina Healthcare [350012] | Hb Molina Mschips - Mlh-Tn Contract | $840 |
| Alt BCBS MS Medicare [450116] | HB MEDICARE ADVANTAGE / MANAGED CARE - | $859 |
| Shared Health Of Ms - Medicare Advantage [450074] | Hb Medicare Advant | $859 |
| Alt BCBS TN Medicare [450115] | HB MEDICARE ADVANTAGE / MANAGED CARE - | $859 |
| American Health Advantage MCR ADV [450117] | HB MEDICARE ADVANTAGE / M | $859 |
| BCBS Medicare Advantage [450110] | Hb Medicare Advantage / Managed Car | $859 |
| Healthsprings Medicare Advantage [450007] | Hb Medicare Advantage / MA | $859 |
| Medicare [400001] | Hb Medicare-Tn Contract | $859 |
| Humana Medicare Advantage [450013] | Hb Medicare Advantage / Managed C | $859 |
| Optum Medicare Advantage [450112] | Hb Medicare Advantage / Managed CA | $859 |
| Medipak Advantage - BCBS Ar [450040] | Hb Medicare Advantage / Managed | $859 |
| Healthy Mississippi - Medicare Advantage HMO [450114] | Hb Medicare Ad | $859 |
| Medicare Priority Health [450072] | Hb Medicare Advantage / Managed CA | $859 |
| Generic Hospice Vbid [10940000101] | Hb Medicare Advantage / Managed C | $859 |
| Carecentrix [450200] | Hb Medicare Advantage / Managed Care - Tn Contr | $859 |
| Wellpoint Medicare [450090] | Hb Medicare Advantage Wellcare/Wellpoint | $859 |
| United Healthcare Medicare [450021] | Hb Medicare Advantage / Managed | $859 |
| Transplant Optum Medicare [450095] | Hb Medicare Advantage / Managed C | $859 |
| Devoted Health [450111] | Hb Medicare Advantage Devoted - Tn Contract | $884 |
| BCBS MEDICAID REPLACEMENT [350011] | HB BLUECARE TN - LeBonheur | $893 |
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