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South Dakota 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 $3,388 · 10th–90th $240–$4,3650%10%20%10th90th$3,388Professionalmedian $479 · 10th–90th $331–$5500%20%10th90th$479$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
$239.88 / $3,388.44 / $7,079.46
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $933.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $616.60 / $616.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $467.74 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,890.45