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Upper Endoscopy With Drainage Of A Fluid Pocket

Wisconsin 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.

Facilitymedian $6,607 · 10th–90th $525$11,7490%10%10th90th$6,607Professionalmedian $813 · 10th–90th $447$1,2590%10%20%10th90th$813$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
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$4,897.79
Typical High
$20,417.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$7,762.47
Typical High
$13,182.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,174.90
Typical High
$1,862.09
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$562.34
Typical High
$3,981.07
Medica
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$630.96
Typical High
$8,317.64
Network Health
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$5,754.40
Typical High
$7,762.47
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$501.19
Typical High
$1,000.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$812.83
Typical High
$1,258.93
Quartz
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$25,118.86
Typical High
$25,118.86
Security Health
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$7,413.10
Typical High
$9,120.11