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California 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 $4,786 · 10th–90th $912–$13,4900%5%10%10th90th$4,786Professionalmedian $257 · 10th–90th $214–$6920%20%10th90th$257$50.0$200.0$1.0K$5.0K$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
$2,238.72 / $6,456.54 / $15,848.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,466.84 / $12,022.64
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $4,265.80 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,023.29 / $1,659.59
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $257.04 / $380.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $257.04 / $741.31
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,011.87 / $28,840.32
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $4,168.69 / $9,549.93