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Diagnostic Esophagus Exam Through the Nose

West Virginia 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?

$155

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $661 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$155$95.50 to $240
FacilityA hospital or hospital-owned outpatient department$661$427 to $1,230

How much rates vary

Facilitymedian $661 · 10th to 90th $123 to $1,413Professionalmedian $155 · 10th to 90th $72 to $295
$50$100$200$500$1K$2Kfacility $661professional $155

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
Facility
Modifier
None
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$123.03
Typical High
$186.21
CareSource
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Facility
Modifier
None
Typical Low
$34.67
Median
$123.03
Typical High
$380.19
Cigna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$218.78
Typical High
$407.38
United
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$660.69
Typical High
$2,511.89
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$144.54
Typical High
$295.12
5 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
$41.69
Median
$61.66
Typical High
$91.20
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.60
Median
$24.55
Typical High
$37.15
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$63.10
Median
$91.20
Typical High
$138.04
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$18.62
Typical High
$27.54
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$12.30
Typical High
$18.62

Where West Virginia 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.

West Virginia· 41st of 51

$155

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.