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Diagnostic Esophagus Exam Through the Nose

Massachusetts 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?

$191

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $191 from a physician practice, and about $1,000 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 8 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$191$95.50 to $269
FacilityA hospital or hospital-owned outpatient department$1,000$112 to $2,570

How much rates vary

Facilitymedian $1,000 · 10th to 90th $93 to $3,715Professionalmedian $191 · 10th to 90th $81 to $457
$100.0$1.0K$10.0Kfacility $1,000professional $191

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
$194.98
Median
$2,238.72
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$169.82
Typical High
$281.84
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$776.25
Typical High
$4,570.88
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$199.53
Typical High
$616.60
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$218.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$501.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$676.08
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$229.09
Typical High
$467.74
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$100.00
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$416.87
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$3,162.28
Typical High
$8,511.38
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$204.17
Typical High
$489.78
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$776.25
Typical High
$4,570.88
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$199.53
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,398.83
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$208.93
Typical High
$524.81

Where Massachusetts sits

The same service costs 1.9 times more in Minnesota than in Kentucky. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Massachusetts $191 · 23rd of 51
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.