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Diagnostic Esophagus Exam Through the Nose

Washington, DC rates for HCPCS 43197

An examination of the esophagus, the tube connecting the throat to the stomach, using a thin, flexible scope passed through the nose rather than the mouth. It allows the clinician to directly view the lining of the esophagus and can include collecting a sample by brushing or rinsing the surface. Because it goes through the nose with a very thin scope, it is often done without sedation, unlike a standard scope passed through the mouth.

Rates data updated October 2026.

How much does Diagnostic Esophagus Exam Through the Nose cost?

$97.72

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

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $85.11 to $209.

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 $2,138 · 10th to 90th $234 to $16,218Professionalmedian $95 · 10th to 90th $79 to $234
$100$500$2K$10Kfacility $2,138professional $95

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
$93.33
Median
$1,698.24
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$169.82
Typical High
$234.42
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$46.77
Median
$79.43
Typical High
$117.49
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$18.62
Median
$31.62
Typical High
$46.77
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$70.79
Median
$117.49
Typical High
$173.78
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$14.13
Median
$23.44
Typical High
$35.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.33
Median
$15.85
Typical High
$23.44
CareFirst
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$87.10
Typical High
$100.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$186.21
Typical High
$263.03
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$213.80
Typical High
$389.05
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
$69.18
Median
$165.96
Typical High
$316.23

Where Washington, DC sits

The same service costs 3.7 times more in Alaska 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.

Washington, DC· 50th of 51

$97.72

AK $355MD $95.50

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.