search again

Nationwide rates for HCPCS 43242

Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)

Facilitymedian $3,236 · 10th–90th $479$8,5110%10%20%10th90th$3,236Professionalmedian $355 · 10th–90th $229$1,3180%20%10th90th$355$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$645.65 / $3,630.78 / $8,511.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $4,168.69 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $831.76 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,511.89 / $6,025.60