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Utah rates for HCPCS 43204

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

Facilitymedian $3,388 · 10th–90th $1,698–$4,5710%10%20%10th90th$3,388Professionalmedian $170 · 10th–90th $123–$3980%20%10th90th$170$50.0$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
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $154.88 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $229.09 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $380.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,715.35 / $5,623.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $302.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $316.23 / $426.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $281.84