Upper GI endoscopy with biopsy at Gundersen Moundview Hospital and Clinics. CPT 43239.
What Gundersen Moundview Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$1,774cash price (self-pay)
$3,493list price
$453–$5,713range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $453 |
| Quartz | All Products | $1,478 |
| Quartz | All Other Self Funded | $1,537 |
| Security Health Plan | Medicare Advantage | $1,607 |
| Anthem | Medicare HMO/PPO | $1,607 |
| Health Partners | Medicare Advantage | $1,607 |
| Quartz | Medicare Advantage | $1,607 |
| Security Health Plan | Medicare + Choice | $1,607 |
| UCARE | Dually Eligible | $1,607 |
| Quartz | Self Funded | $1,642 |
| UCARE | MSHO/Minnesota Special Needs | $1,677 |
| UCARE | Non-Dually Eligible | $1,677 |
| Quartz | Level Funded | $1,694 |
| Health Partners | Medicaid HMO | $1,747 |
| Alliance | Premier/All Products | $1,853 |
| Alliance | Comprehensive/All Products | $1,853 |
| Quartz | Fully Insured | $1,904 |
| Health Partners | Medicare Cost | $2,096 |
| Anthem | State Specific | $2,538 |
| Cigna | All Products | $2,693 |
| Dean Health Plan | ASO | $2,743 |
| Group Health of South Central | All Products | $2,794 |
| Trilogy | All Products | $2,794 |
| UCARE | Qualified Health Plan | $2,794 |
| Anthem | Medicaid | $2,846 |
| Group Health Eau Claire | Medicaid HMO | $2,846 |
| Group Health of South Central | Medicaid HMO | $2,846 |
| Iowa Total Care | Medicaid | $2,846 |
| Managed Health Service | Managed Medicaid | $2,846 |
| Quartz | Medicaid_Badgercare | $2,846 |
Inpatient
$1,774cash price (self-pay)
$3,493list price
$1,478–$3,388range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $2,057 |
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All common services at Gundersen Moundview Hospital and Clinics