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Diagnostic Esophagus Exam Through the Nose

Illinois 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 July 2026.

How much does Diagnostic Esophagus Exam Through the Nose cost?

$186

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $1,259 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$95.50 to $245
FacilityA hospital or hospital-owned outpatient department$1,259$437 to $2,692

How much rates vary

Facilitymedian $1,259 · 10th to 90th $158 to $5,129Professionalmedian $178 · 10th to 90th $81 to $339
$100$200$500$1K$2K$5K$10Kfacility $1,259professional $178

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
$158.49
Median
$1,258.93
Typical High
$5,370.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$177.83
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$1,230.27
Typical High
$1,659.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$190.55
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$251.19
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$199.53
Typical High
$371.54
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$316.23
Typical High
$676.08
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$104.71
Typical High
$257.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$1,949.84
Typical High
$4,265.80
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$181.97
Typical High
$346.74

Where Illinois sits

The same service costs 1.9 times more in Minnesota than in Kentucky. 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.

Illinois· 28th of 51

$186

MN $288KY $151

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.