Upper endoscopy with biopsy in Madison, WI costs $1,414 to $2,857. Here's every hospital's price.
4 hospitals in the Madison, WI metro area publish a cash price for upper endoscopy with biopsy (CPT 43239). We read their files every month so you don't have to.
Across the Madison, WI metro area, 4 hospitals list a cash price for upper endoscopy with biopsy (CPT 43239). The lowest is $1,414 at Unitypoint Health - Meriter, the median is $1,581 and the highest is $2,857 at Ssm Health St Mary's Hospital - Madison. The most expensive hospital lists 2.0 times the cheapest for the same code.
The Madison, WI median of $1,581 is 14% above the national median of $1,383 across 898 US hospitals with a cash price for this code.
4 of these hospitals also publish the rates they negotiated with insurers, from $62 to $6,607. With insurance you pay a share of the negotiated rate, which is sometimes higher than the cash price; you may ask for the cash price instead.
The files behind these prices are dated between January 2026 and April 2026. 4 other hospitals in the metro area have no readable price for this code: some publish no file, some block automated reading, some leave the code out. They are listed below so you can call them.
Sorted by cash price
Hospital facility fee onlyMadison · 10 mi · File Jan 2026
Portage · 34 mi · File Apr 2026
Madison · 9 mi · File Apr 2026
Madison · 10 mi · File Apr 2026
What's in the price
The hospital facility fee for CPT 43239. The doctor, anesthesia and lab work usually bill separately.
Cash vs. insured
Cash is what you pay without insurance. With insurance you pay a share of the negotiated rate, which can be higher than cash. You may ask for the cash price.
What to say on the phone
"I'd like the self-pay price for CPT 43239, in writing, and whether it covers facility, physician and anesthesia."
About upper endoscopy with biopsy
CPT 43239 is an upper endoscopy (EGD) in which tissue samples are taken from the esophagus, stomach or duodenum. It is the usual code when the exam is done to check for celiac disease, H. pylori, Barrett's esophagus or unexplained inflammation, since all of those need a sample to confirm.
What the price covers
The facility fee: the endoscopy room, nursing, the scope, biopsy forceps, sedation monitoring and recovery. Separately billed: the gastroenterologist, the anesthesia provider and the pathologist. Celiac work-ups often take four to six samples, so ask whether pathology is billed per specimen.
Related codes
- 43235: EGD, diagnostic, no biopsy
- 43239: EGD with biopsy (this page)
Hospitals typically price 43239 slightly above 43235. If only one is listed, it is a fair guide for the other.
Why prices vary
The spread within a metro area is usually several times. It tracks the hospital's overall pricing level, not the difficulty of the exam. Community hospitals and hospital-owned outpatient centers sit at the low end; academic medical centers at the high end.
Questions to ask
- What is the self-pay price for 43239 including pathology?
- How many samples are planned, and is pathology billed per sample?
- Who provides anesthesia, and what is their cash rate?
Hospitals in Madison, WI without a price for this procedure
Listed so you know who to call. The reason is what we found on their website.
- Columbus Community HospitalNo website on record
- Stoughton HospitalNo website on record
- The Monroe ClinicFile found, not read yet
- Upland Hills HealthNo website on record