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Diagnostic Esophagus Exam Through the Nose

New Jersey 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 New Jersey, 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 $5,370 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$178$87.10 to $229
FacilityA hospital or hospital-owned outpatient department$5,370$3,548 to $7,079

How much rates vary

Facilitymedian $5,370 · 10th to 90th $347 to $10,471Professionalmedian $178 · 10th to 90th $76 to $380
$50.0$200.0$1.0K$5.0K$20.0Kfacility $5,370professional $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
$239.88
Median
$5,495.41
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$169.82
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$204.17
Typical High
$467.74
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$407.38
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$3,019.95
Typical High
$4,677.35
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$194.98
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$4,897.79
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$162.18
Typical High
$363.08

Where New Jersey 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.

New Jersey $186 · 29th 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.