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Colorado 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 $4,365 · 10th–90th $437–$8,5110%5%10%10th90th$4,365Professionalmedian $331 · 10th–90th $234–$9120%20%40%10th90th$331$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $3,235.94 / $6,606.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $6,456.54 / $10,964.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,862.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $331.13 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $3,801.89 / $6,606.93