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Maryland 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 $794 · 10th–90th $288–$3,8020%5%10%10th90th$794Professionalmedian $263 · 10th–90th $200–$4470%20%10th90th$263$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$288.40 / $1,047.13 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $912.01 / $1,148.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $588.84 / $1,445.44