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Wisconsin rates for HCPCS 43238

Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)

Facilitymedian $4,365 · 10th–90th $468–$7,9430%5%10%10th90th$4,365Professionalmedian $479 · 10th–90th $263–$8510%10%20%10th90th$479$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$467.74 / $7,079.46 / $15,135.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,570.88 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $691.83 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $380.19 / $3,715.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $398.11 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $3,890.45 / $4,570.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $478.63 / $741.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,897.79 / $4,897.79
Quartz
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$309.03 / $2,630.27 / $3,890.45
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $6,760.83