Upper GI endoscopy with biopsy at Grace Surgical Hospital. CPT 43239.
What Grace Surgical Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$884–$4,711range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcbs | Vapc3 Government | $884 |
| Baylor Scott And White | Individual Bsw Premier Exchange | $895 |
| Aetna | Medicare Managed Care Plan | $911 |
| Superior | Wellcare Medicare Managed Care Plan | $957 |
| Unitedhealthcare | Medicare Managed Care Plan | $961 |
| Baylor Scott And White | Group Bsw Premier/Covenant Preferred All Comm | $1,082 |
| Bcbs | Hmo | $1,202 |
| Bcbs | Par Traditional | $1,391 |
| Baylor Scott And White | Group Bsw Plus All Commercial Plans | $1,482 |
| Bcbs | Ers Hmo | $1,595 |
| Bcbs | Ppo | $1,666 |
| Cigna | Ppo | $2,914 |
| Covenant Preferred | All Commercial Plans | $3,218 |
| Aetna | Preferred Other Commercial Plan | $3,400 |
| Unitedhealthcare | All Commercial Plans | $4,465 |
| Aetna | All Commercial Plans | $4,566 |
| Cigna | New Buisness Other Commercial Plan | $4,574 |
| Cigna | Oap | $4,711 |
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