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Upper GI Endoscopy With Esophageal Balloon Dilation

Illinois rates for HCPCS 43249

A thin flexible scope is passed through the mouth to examine the esophagus, stomach, and the beginning of the small intestine, and a balloon is then passed through the scope and inflated to stretch open a narrowed part of the esophagus. It is done to relieve difficulty swallowing caused by the narrowing. This version uses a balloon under a set diameter; stretching with a large-diameter balloon is a different service.

Rates data updated July 2026.

How much does Upper GI Endoscopy With Esophageal Balloon Dilation cost?

$2,259

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

Insurers have agreed to pay about $2,259 for this procedure. That total is two separate charges: $309 to the doctor who performs it, and $1,950 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$309$166 to $1,288
Facility feeThe hospital or surgery center$1,950$1,096 to $4,169

How much rates vary

Facilitymedian $1,950 · 10th to 90th $759 to $7,079Professionalmedian $309 · 10th to 90th $148 to $1,778
$50$200$1K$5Kfacility $1,950professional $309

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
$724.44
Median
$1,949.84
Typical High
$7,079.46
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$77.62
Median
$194.98
Typical High
$891.25
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$30.90
Median
$77.62
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$295.12
Typical High
$1,778.28
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$131.83
Typical High
$933.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$2,511.89
Typical High
$3,311.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$323.59
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,698.24
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$338.84
Typical High
$1,778.28
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$1,071.52
Typical High
$2,454.71
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$190.55
Typical High
$1,318.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$2,089.30
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$295.12
Typical High
$1,778.28

Where Illinois sits

The same service costs 4.6 times more in California than in Montana. 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.

Physician feeFacility fee

Illinois· 30th of 51

$2,259

$309 physician + $1,950 facility

CA $5,438MT $1,175

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.