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Upper Digestive Endoscopy With Stretching Of A Narrowed Area

Washington, DC 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 October 2026.

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

$200

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $182 to $631.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,138 · 10th to 90th $501 to $16,218Professionalmedian $200 · 10th to 90th $170 to $741
$200$500$1K$2K$5K$10K$20Kfacility $2,138professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$1,862.09
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$501.19
Typical High
$741.31
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$100.00
Median
$107.15
Typical High
$371.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$39.81
Median
$42.66
Typical High
$147.91
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$151.36
Median
$158.49
Typical High
$549.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$30.20
Median
$31.62
Typical High
$109.65
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.95
Median
$21.38
Typical High
$74.13
CareFirst
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$186.21
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$436.52
Typical High
$758.58
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$645.65
Median
$724.44
Typical High
$1,412.54
United
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$2,511.89
Typical High
$27,542.29
United
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$346.74
Typical High
$1,096.48

Where Washington, DC sits

The same service costs 4.7 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 51st of 51

$200

AK $933DC $200

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.