Upper GI endoscopy with biopsy at Southwestern Vermont Medical Center. CPT 43239.
What Southwestern Vermont Medical Center publishes for this service, straight from its standard-charges file, last updated January 1, 2025.
Outpatient / ER
$571cash price (self-pay)
$816list price
$87.68–$1,837range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CDPHP | Medicaid/CHP | $170 |
| MVP | Medicaid | $192 |
| MVP | Essential plan 1,2,5,6 | $192 |
| UHC | Medicaid | $195 |
| BMC | Healthnet Plan | $205 |
| HNE | Medicaid | $205 |
| CDPHP | Essential Plan 3 & 4 | $217 |
| CDPHP | Essential Plan 1 & 2 | $217 |
| MVP | NY Exchange Individual Plans | $273 |
| Health New England | Commercial | $283 |
| Allegiance | SWVT Employee Only | $332 |
| UHC | Commercial | $332 |
| Tufts | Commercial | $333 |
| CDPHP | Commercial/Exchange | $339 |
| CIGNA | Medicare Advantage | $349 |
| CDPHP | Medicare | $349 |
| Blue Cross | Medicare | $349 |
| Fidelis | Medicare | $349 |
| HNE | Medicare | $349 |
| Humana | Medicare | $349 |
| MVP | Medicare | $349 |
| UHC | Medicare | $349 |
| Wellcare | Medicare | $349 |
| Fidelis | Medicaid | $349 |
| Fidelis | CHP | $349 |
| Fidelis | Essential (Aliessa) | $349 |
| Aetna | Medicare | $349 |
| MVP | VT Commercial/VT Exchange | $359 |
| MVP | NY Commercial/ Exchange Group plans | $359 |
| Aetna | PPO | $361 |
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