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Upper Endoscopy With Ultrasound-Guided Biopsy

Hawaii rates for HCPCS 43242

A flexible camera is passed through the mouth into the food pipe, stomach and first part of the small intestine, with an ultrasound probe on its tip that sees through the gut wall into nearby organs such as the pancreas, bile duct and lymph nodes. A fine needle is then passed through the wall under ultrasound guidance to take samples from a lump or gland. The ultrasound survey covers the full upper tract rather than one area alone.

Rates data updated July 2026.

Facilitymedian $2,818 · 10th–90th $1,148$3,8900%20%40%10th90th$2,818Professionalmedian $275 · 10th–90th $229$3800%50%10th90th$275$200.0$500.0$1.0K$2.0K

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
$1,148.15
Median
$2,818.38
Typical High
$3,890.45
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$275.42
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80