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South Dakota rates for HCPCS 43204

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

Facilitymedian $282 · 10th–90th $126–$4,3650%20%10th90th$282Professionalmedian $182 · 10th–90th $126–$3800%20%10th90th$182$100.0$200.0$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $2,290.87 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $141.25 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $309.03 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $251.19 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $257.04 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $316.23 / $316.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $239.88 / $363.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $316.23 / $316.23