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Upper Endoscopy With Limited Ultrasound

Vermont rates for HCPCS 43237

A flexible camera with an ultrasound probe on its tip is passed through the mouth, so the doctor can both look at the lining and see through the wall into the tissue beneath and beside it. Here the ultrasound part is limited to one area of the upper digestive tract and the structures right next to it. No tissue sample is taken as part of it.

Rates data updated October 2026.

How much does Upper Endoscopy With Limited Ultrasound cost?

$5,827

Typical total for the visit. In Vermont, October 2026.

Insurers have agreed to pay about $5,827 for this procedure. That total is two separate charges: $331 to the doctor who performs it, and $5,495 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$331$275 to $331
Facility feeThe hospital or surgery center$5,495$3,162 to $5,495

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,259 to $5,495Professionalmedian $331 · 10th to 90th $240 to $389
$200$500$1K$2K$5Kfacility $5,495professional $331

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$5,495.41
Aetna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$257.04
Typical High
$275.42
BCBS Vermont
Setting
Facility
Modifier
None
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,630.78
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$389.05
Typical High
$389.05
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$1,995.26
Cigna
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$331.13
Typical High
$354.81
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$295.12
Typical High
$501.19
United
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
United
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$275.42
Typical High
$398.11

Where Vermont sits

The same service costs 9.6 times more in Vermont than in Montana. 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.

Physician feeFacility fee

Vermont· 1st of 51

$5,827

$331 physician + $5,495 facility

VT $5,827MT $604

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.