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Upper GI Endoscopy With Esophageal Balloon Dilation

Kentucky 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?

$2,470

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

Insurers have agreed to pay about $2,470 for this procedure. That total is two separate charges: $282 to the doctor who performs it, and $2,188 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$282$174 to $912
Facility feeThe hospital or surgery center$2,188$1,318 to $3,715

How much rates vary

Facilitymedian $2,188 · 10th to 90th $282 to $5,370Professionalmedian $282 · 10th to 90th $148 to $1,259
$50$100$200$500$1K$2K$5Kfacility $2,188professional $282

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
$223.87
Median
$1,862.09
Typical High
$5,370.32
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$72.44
Median
$97.72
Typical High
$630.96
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$29.51
Median
$38.90
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$275.42
Typical High
$1,288.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$158.49
Typical High
$190.55
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,818.38
Typical High
$5,495.41
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$309.03
Typical High
$831.76
CareSource
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$173.78
Typical High
$223.87
CareSource
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$1,023.29
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Cigna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$457.09
Typical High
$5,754.40
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$2,089.30
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$263.03
Typical High
$1,479.11

Where Kentucky 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

Kentucky· 26th of 51

$2,470

$282 physician + $2,188 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.