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Utah 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 $3,981 · 10th–90th $2,512–$9,3330%10%10th90th$3,981Professionalmedian $372 · 10th–90th $316–$4900%20%10th90th$372$200.0$500.0$1.0K$2.0K$5.0K$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
$2,454.71 / $3,981.07 / $9,332.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,715.35 / $5,623.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61