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Diagnostic Esophagus Exam Through the Nose

Montana 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?

$178

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $209 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 5 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$174$110 to $275
FacilityA hospital or hospital-owned outpatient department$209$138 to $324

How much rates vary

Facilitymedian $209 · 10th to 90th $115 to $363Professionalmedian $174 · 10th to 90th $79 to $380
$100$200$500$1K$2Kfacility $209professional $174

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
$79.43
Median
$169.82
Typical High
$426.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$199.53
Typical High
$407.38
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$288.40
Typical High
$346.74
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$288.40
Typical High
$346.74
Providence
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$204.17
Typical High
$407.38
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$204.17
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$354.81

Where Montana 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.

Montana· 35th of 51

$178

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.