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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 July 2026.

How much does Diagnostic Esophagus Exam Through the Nose cost?

$155

Typical negotiated rate. In West Virginia, July 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 $186 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 4 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$155$83.18 to $191
FacilityA hospital or hospital-owned outpatient department$186$83.18 to $186

How much rates vary

Facilitymedian $186 · 10th to 90th $83 to $1,413Professionalmedian $155 · 10th to 90th $78 to $240
$50$100$200$500$1K$2Kfacility $186professional $155

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
$83.18
Median
$186.21
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$158.49
Typical High
$234.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$107.15
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$123.03
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$204.17
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$1,584.89
Typical High
$2,511.89
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$144.54
Typical High
$309.03

Where West Virginia 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.

West Virginia· 50th of 51

$155

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.