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North Carolina 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 $3,020 · 10th–90th $282–$8,1280%5%10%10th90th$3,020Professionalmedian $676 · 10th–90th $676–$6760%50%100%$676$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $3,467.37 / $8,511.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $912.01 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $851.14 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $2,398.83 / $5,623.41
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,011.87 / $28,840.32