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Virginia 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 $1,660 · 10th–90th $302–$6,9180%5%10%10th90th$1,660Professionalmedian $316 · 10th–90th $224–$6760%10%10th90th$316$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
$371.54 / $3,311.31 / $7,079.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $870.96 / $977.24
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $269.15 / $691.83
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $588.84 / $676.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $416.87 / $758.58
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $457.09 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $2,754.23 / $5,370.32