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Upper Endoscopy With Drainage Of A Fluid Pocket

Virginia rates for HCPCS 43240

An examination of the food pipe, stomach and first part of the small intestine with a flexible scope, during which a fluid collection pressing against the stomach or intestinal wall — most often a pocket left behind after inflammation of the pancreas — is drained. The doctor makes an opening through the wall into the collection and leaves one or more short tubes in place so it empties into the gut. Ultrasound from the tip of the scope is normally used to find a safe route.

Rates data updated July 2026.

How much does Upper Endoscopy With Drainage Of A Fluid Pocket cost?

$661

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $661 for this service. Most negotiated rates run $468 to $3,631.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $676 · 10th to 90th $407 to $7,079Professionalmedian $447 · 10th to 90th $331 to $676
$200$500$1K$2K$5K$10Kfacility $676professional $447

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$3,235.94
Typical High
$7,244.36
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$6,760.83
Typical High
$7,413.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$3,890.45
Typical High
$4,786.30
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$398.11
Typical High
$676.08
Medcost
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$562.34
Typical High
$831.76
Medcost
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$524.81
Typical High
$831.76
Sentara
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$489.78
Typical High
$1,778.28
United
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$5,754.40
Typical High
$13,182.57

Where Virginia sits

The same service costs 26.3 times more in Wyoming than in North Dakota. 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.

Virginia· 44th of 50

$661

WY $10,471ND $398

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.