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Ohio 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 $2,884 · 10th–90th $490–$8,9130%5%10th90th$2,884$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $3,019.95 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $2,630.27 / $5,888.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $275.42 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $512.86 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,202.26 / $4,466.84
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,290.87 / $5,248.07