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Removal of a Pouch From the Esophagus

Montana rates for HCPCS 43135

Surgery that removes a pouch which has ballooned out through the wall of the esophagus, the tube carrying food from the throat to the stomach. The tight muscle below the pouch, which drove it to form in the first place, is commonly divided during the same operation.

Rates data updated July 2026.

How much does Removal of a Pouch From the Esophagus cost?

$4,554

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

Insurers have agreed to pay about $4,554 for this procedure. That total is two separate charges: $2,042 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$2,042$1,445 to $2,512
Facility feeThe hospital or surgery center$2,512$2,042 to $2,570

How much rates vary

Facilitymedian $2,512 · 10th to 90th $1,514 to $3,020Professionalmedian $2,042 · 10th to 90th $1,318 to $3,631
$100$200$500$1K$2K$5Kfacility $2,512professional $2,042

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
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,445.44
Typical High
$7,413.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,995.26
Typical High
$4,365.16
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,511.89
Typical High
$2,818.38
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$2,511.89
Typical High
$2,818.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$2,041.74
Typical High
$3,548.13
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$2,290.87
Typical High
$3,890.45
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70
United
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$2,398.83
Typical High
$3,090.30

Where Montana sits

The same service costs 7.1 times more in Maine than in Maryland. 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.

Physician feeFacility fee

Montana· 29th of 50

$4,554

$2,042 physician + $2,512 facility

ME $14,165MD $1,985

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.