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Upper Digestive Endoscopy With Stretching Of A Narrowed Area

California rates for HCPCS 43245

This is an endoscopy in which a thin, flexible scope with a camera is passed through the mouth into the stomach and the duodenum, the first part of the small intestine, during which a narrowed section in the stomach or duodenum is gently stretched open using a balloon or dilating instrument passed through the scope. It combines diagnostic viewing of the stomach and duodenum with treatment of the narrowing in the same procedure.

Rates data updated July 2026.

How much does Upper Digestive Endoscopy With Stretching Of A Narrowed Area cost?

$5,655

Typical total for the visit. In California, July 2026.

Insurers have agreed to pay about $5,655 for this procedure. That total is two separate charges: $407 to the doctor who performs it, and $5,248 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 14 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$407$195 to $813
Facility feeThe hospital or surgery center$5,248$3,548 to $7,943

How much rates vary

Facilitymedian $5,248 · 10th to 90th $631 to $13,490Professionalmedian $407 · 10th to 90th $162 to $1,230
$100.0$1.0K$10.0Kfacility $5,248professional $407

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$6,025.60
Typical High
$16,982.44
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$83.18
Median
$100.00
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$426.58
Typical High
$1,148.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$154.88
Typical High
$295.12
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$5,888.44
Typical High
$13,489.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$436.52
Typical High
$1,230.27
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$4,073.80
Typical High
$8,511.38
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$275.42
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$1,000.00
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$346.74
Typical High
$1,122.02
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$239.88
Typical High
$1,148.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$602.56
Typical High
$1,230.27
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$28,840.32
Lucent Health
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$4,168.69
Median
$4,897.79
Typical High
$4,897.79
Molina
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$812.83
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$331.13
Typical High
$1,047.13
Providence
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$380.19
Typical High
$1,288.25
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$1,995.26
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$398.11
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$4,168.69
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$323.59
Typical High
$954.99

Where California sits

The same service costs 8.3 times more in New Jersey than in Montana. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeCalifornia $5,655 · 2nd of 51
NJ $5,817MT $702

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.