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Upper Endoscopy With Biopsy

Ohio 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 July 2026.

How much does Upper Endoscopy With Biopsy cost?

$2,794

Typical total for the visit. In Ohio, July 2026.

Insurers have agreed to pay about $2,794 for this procedure. That total is two separate charges: $282 to the doctor who performs it, and $2,512 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 10 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$282$151 to $407
Facility feeThe hospital or surgery center$2,512$955 to $3,890

How much rates vary

Facilitymedian $2,512 · 10th to 90th $562 to $7,079Professionalmedian $282 · 10th to 90th $126 to $589
$10.0$100.0$1.0K$10.0Kfacility $2,512professional $282

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$2,570.40
Typical High
$7,079.46
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$74.13
Median
$229.09
Typical High
$562.34
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$29.51
Median
$91.20
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$257.04
Typical High
$616.60
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$128.82
Typical High
$186.21
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$2,187.76
Typical High
$4,073.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$323.59
Typical High
$524.81
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$186.21
Typical High
$467.74
CareSource
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$181.97
CareSource
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$416.87
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$524.81
Typical High
$794.33
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Cigna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$331.13
Typical High
$645.65
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$1,318.26
Typical High
$3,019.95
Medical Mutual of Ohio
Setting
Facility
Modifier
22 · Increased work
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Medical Mutual of Ohio
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Medical Mutual of Ohio
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$204.17
Typical High
$524.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$154.88
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$562.34
Typical High
$691.83
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$338.84
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$2,089.30
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$288.40
Typical High
$575.44

Where Ohio sits

The same service costs 5.9 times more in California than in Montana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeOhio $2,794 · 22nd of 51
CA $5,043MT $859

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.