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Montana rates for HCPCS 43204

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

Facilitymedian $240 · 10th–90th $174–$4680%20%10th90th$240Professionalmedian $191 · 10th–90th $126–$3720%20%10th90th$191$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $478.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $234.42 / $371.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $234.42 / $371.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $489.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $213.80 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $389.05