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California rates for HCPCS 43204

Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.95 / $5,812.00 / $17,902.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.37 / $198.63 / $713.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.00 / $4,417.00 / $9,244.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.27 / $361.89 / $587.27
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.90 / $100.00 / $4,970.60
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.48 / $163.90 / $372.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$339.00 / $1,091.68 / $2,915.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.82 / $230.33 / $482.04
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.75 / $279.23 / $528.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.62 / $167.09 / $306.33
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.20 / $4,901.45 / $12,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,865.75 / $1,865.75 / $1,865.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $191.97
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.44 / $203.78 / $416.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.75 / $242.76 / $393.16
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.70 / $442.70 / $442.70
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.21 / $279.23 / $502.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,433.90 / $3,964.00 / $9,131.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.53 / $185.35 / $374.53