Upper GI endoscopy with biopsy at Ascension Providence. CPT 43239.
What Ascension Providence publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$335–$1,485range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Star | 975_bcbs Star Outpatient 20241201 | $335 |
| Medicaid Replacement 100% | 903_medicaid Replacement 100% Outpatient 2 | $335 |
| Molina Medicaid Replacement Chip | 908_molina Chip Outpatient 20241201 | $335 |
| Superior Chip/Chip Perinate | 910_superior Chip Outpatient 20241201 | $335 |
| Superior Star | 904_superior Star Outpatient 20241201 | $335 |
| Superior Star Plus | 907_superior Star Plus Outpatient 20241201 | $335 |
| Swhp Rightcare Star | 905_swhp Rightcare Star Outpatient 20241201 | $335 |
| UHC Star | 928_uhc Star Outpatient 20250701 | $335 |
| UHC Star Kids | 909_uhc Star Kids Outpatient 20241201 | $335 |
| UHC Star Plus | 906_uhc Star Plus Outpatient 20241201 | $335 |
| Wellpoint Star | 902_wellpoint (Amerigroup) Star Outpatient 20241201 | $335 |
| BCBS Mybluehealth | 872_blue Cross Blue Shield Myblueheath 20250101 | $629 |
| Firstcare Focus Network | 130_firstcare Focus Network 20131001 | $758 |
| BCBS Advantage HMO | 871_blue Cross Blue Shield Advantage HMO 20250101 | $786 |
| Ascension Complete Medicare Replacement | 920_medicare Advantage Ascen | $919 |
| Medicare Advantage 100 Percent | 879_medicare Advantage 100% Outpatien | $919 |
| Tricare | 877_tricare Outpatient 20250101 | $919 |
| Va | 887_veterans Administration Outpatient 20250101 | $919 |
| Wellcare Allwell Medicare Advantage | 918_wellcare Allwell Medicare Ad | $919 |
| Aetna Medicare Replacement | 880_medicare Advantage Aetna Outpatient 2 | $937 |
| UHC Medicare Replacement | 883_medicare Advantage United Healthcare Ou | $937 |
| Swhp Medicare Replacement | 882_medicare Advantage Scott And White Out | $946 |
| Smarthealth | 875_smarthealth Outpatient 20250101 | $1,286 |
| BCBS Essentials HMO | 870_blue Cross Blue Shield HMO Essentials 202501 | $1,336 |
| Green Imaging | 932_green Imaging Outpatient 20250101 | $1,378 |
| Superior Ambetter | 876_superior Ambetter Outpatient 20250101 | $1,378 |
| BCBS PPO | 869_blue Cross Blue Shield PPO 20250101 | $1,485 |
Inpatient
—cash price (self-pay)
—list price
$919–$1,378range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ascension Complete Medicare Replacement | 995_medicare Advantage Ascen | $919 |
| Medicare Advantage 100 Percent | 988_medicare Advantage 100% Inpatient | $919 |
| Tricare | 986_tricare Inpatient 20251001 | $919 |
| Va | 992_veterans Administration Inpatient 20251001 | $919 |
| Wellcare Allwell Medicare Advantage | 994_wellcare Allwell Medicare Ad | $919 |
| Aetna Medicare Replacement | 989_medicare Advantage Aetna Inpatient 20 | $937 |
| UHC Medicare Replacement | 991_medicare Advantage United Healthcare In | $937 |
| Swhp Medicare Replacement | 990_medicare Advantage Scott And White Inp | $946 |
| Smarthealth | 984_smarthealth Inpatient 20251001 | $1,286 |
| Superior Ambetter | 985_superior Ambetter Inpatient 20251001 | $1,378 |
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