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Pennsylvania 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 $4,074 · 10th–90th $631–$8,7100%5%10th90th$4,074$200.0$1.0K$5.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $4,168.69 / $8,709.64
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,467.37 / $13,182.57
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,288.25 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,288.25 / $1,584.89
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $4,570.88 / $9,549.93
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,019.95 / $6,456.54
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $2,570.40 / $8,511.38
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $251.19 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $2,630.27 / $6,309.57