go back

Diagnostic Esophagus Exam Through the Nose

Vermont 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?

$209

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $209 for this service. Most negotiated rates run $138 to $331.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $468 · 10th to 90th $316 to $1,259Professionalmedian $209 · 10th to 90th $112 to $331
$100$200$500$1Kfacility $468professional $209

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
Professional
Modifier
None
Typical Low
$91.20
Median
$194.98
Typical High
$218.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$18.20
Median
$38.90
Typical High
$43.65
Cigna
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$467.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$194.98
Typical High
$331.13
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$263.03
Typical High
$501.19
United
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
United
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$204.17
Typical High
$354.81
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$45.71
Median
$97.72
Typical High
$109.65
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$67.61
Median
$144.54
Typical High
$162.18
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.49
Median
$29.51
Typical High
$32.36
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.12
Median
$19.50
Typical High
$21.88

Where Vermont 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.

Vermont· 17th of 51

$209

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.