go back

Upper GI Endoscopy With Esophageal Balloon Dilation

New Jersey 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?

$4,838

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $4,838 for this procedure. That total is two separate charges: $372 to the doctor who performs it, and $4,467 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$372$162 to $1,259
Facility feeThe hospital or surgery center$4,467$2,455 to $6,166

How much rates vary

Facilitymedian $4,467 · 10th to 90th $1,148 to $8,511Professionalmedian $372 · 10th to 90th $141 to $2,042
$100$200$500$1K$2K$5K$10Kfacility $4,467professional $372

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
$1,148.15
Median
$4,466.84
Typical High
$8,511.38
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$83.18
Median
$128.82
Typical High
$1,071.52
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$33.11
Median
$52.48
Typical High
$426.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$363.08
Typical High
$2,041.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$147.91
Typical High
$190.55
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$3,890.45
Typical High
$11,220.18
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$346.74
Typical High
$2,089.30
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$1,047.13
Typical High
$2,398.83
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$5,888.44
Typical High
$8,709.64
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$1,023.29
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$4,897.79
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$251.19
Typical High
$1,778.28

Where New Jersey 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

New Jersey· 3rd of 51

$4,838

$372 physician + $4,467 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.