Upper GI endoscopy with biopsy at Gundersen TriCounty Hospital and Clinics. CPT 43239.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$1,708cash price (self-pay)
$2,694list price
$453–$5,713range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $453 |
| Quartz | All Products | $1,140 |
| Quartz | All Other Self Funded | $1,185 |
| Quartz | Self Funded | $1,266 |
| Quartz | Level Funded | $1,307 |
| UCARE | Non-Dually Eligible | $1,401 |
| UCARE | MSHO/Minnesota Special Needs | $1,401 |
| UCARE | Dually Eligible | $1,401 |
| Quartz | Fully Insured | $1,468 |
| Anthem | Medicare HMO/PPO | $1,589 |
| Humana | Medicare Advantage | $1,589 |
| Quartz | Medicare Advantage | $1,589 |
| UHC | Medicare Advantage | $1,589 |
| UHC | All Payer Appendix | $1,940 |
| Cigna | All Products | $2,077 |
| Alliance | Premier/All Products | $2,155 |
| Group Health of South Central | All Products | $2,155 |
| Trilogy | All Products | $2,155 |
| UCARE | Qualified Health Plan | $2,155 |
| Anthem | Medicaid | $2,225 |
| Group Health Eau Claire | Medicaid HMO | $2,225 |
| Group Health of South Central | Medicaid HMO | $2,225 |
| Iowa Total Care | Medicaid | $2,225 |
| Managed Health Service | Managed Medicaid | $2,225 |
| Quartz | Medicaid_Badgercare | $2,225 |
| Aspirus Arise Health | All Products | $2,236 |
| Allied National | Core Value Programs | $2,290 |
| Sana | All Products | $2,317 |
| Group Health Eau Claire | All Products | $2,425 |
| Alliance | Comprehensive/All Products | $2,559 |
Inpatient
$1,708cash price (self-pay)
$2,694list price
$1,140–$2,559range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $1,587 |
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All common services at Gundersen TriCounty Hospital and Clinics