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Upper Endoscopy With Biopsy

Vermont 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?

$380

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $380 for this service. Most negotiated rates run $186 to $513.

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 $2,754 · 10th to 90th $741 to $4,898Professionalmedian $372 · 10th to 90th $138 to $1,000
$100$200$500$1K$2K$5Kfacility $2,754professional $372

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. 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
Global
Typical Low
$741.31
Median
$2,691.53
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$371.54
Typical High
$1,000.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,818.38
Typical High
$3,801.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$309.03
Typical High
$691.83
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$630.96
Typical High
$977.24
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$416.87
Typical High
$794.33

Where Vermont sits

The same service costs 2.4 times more in Wyoming than in Montana. 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.

Vermont· 14th of 51

$380

WY $550MT $229

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.