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Wisconsin 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 $4,467 · 10th–90th $550–$7,4130%10%20%10th90th$4,467Professionalmedian $537 · 10th–90th $302–$9550%20%10th90th$537$1.0$5.0$20.0$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
$524.81 / $6,456.54 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,570.88 / $7,079.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $776.25 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $524.81 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $549.54 / $4,897.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $3,890.45 / $4,570.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $537.03 / $831.76
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $4,897.79 / $4,897.79
Quartz
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $6,760.83