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Upper Endoscopy With Biopsy

Washington, DC rates for HCPCS 43239

A procedure in which a thin, flexible scope with a camera is passed through the mouth to examine the esophagus, stomach, and the first part of the small intestine, with one or more tissue samples taken during the exam for laboratory testing. It's used both to look directly at the lining of these organs and to sample any areas of concern, such as suspicious tissue or ulcers. Patients are typically sedated for comfort during the exam.

Rates data updated October 2026.

How much does Upper Endoscopy With Biopsy cost?

$182

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $182 for this service. Most negotiated rates run $148 to $398.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,549 · 10th to 90th $339 to $8,511Professionalmedian $174 · 10th to 90th $132 to $468
$200$500$1K$2K$5K$10K$20Kfacility $1,549professional $174

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$1,174.90
Typical High
$4,265.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$363.08
Typical High
$467.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$79.43
Median
$154.88
Typical High
$229.09
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$61.66
Typical High
$93.33
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$117.49
Median
$229.09
Typical High
$346.74
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$23.44
Median
$46.77
Typical High
$69.18
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.85
Median
$30.90
Typical High
$46.77
CareFirst
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$147.91
Typical High
$186.21
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$338.84
Typical High
$512.86
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$457.09
Typical High
$891.25
United
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$2,511.89
Typical High
$27,542.29
United
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$281.84
Typical High
$660.69

Where Washington, DC sits

The same service costs 4.5 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 51st of 51

$182

MN $813DC $182

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.