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Virginia rates for HCPCS 43240

Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)

Facilitymedian $832 · 10th–90th $417–$7,0790%10%10th90th$832Professionalmedian $468 · 10th–90th $331–$6760%10%10th90th$468$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$562.34 / $3,235.94 / $7,244.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $6,760.83 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $3,890.45 / $4,786.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $398.11 / $676.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $562.34 / $831.76
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $524.81 / $831.76
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $5,495.41 / $12,882.50