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Upper GI Endoscopy With Esophageal Balloon Dilation

South Dakota 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?

$3,445

Typical total for the visit. In South Dakota, July 2026.

Insurers have agreed to pay about $3,445 for this procedure. That total is two separate charges: $355 to the doctor who performs it, and $3,090 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$355$145 to $1,862
Facility feeThe hospital or surgery center$3,090$2,455 to $3,715

How much rates vary

Facilitymedian $3,090 · 10th to 90th $912 to $5,012Professionalmedian $355 · 10th to 90th $65 to $3,020
$50$100$200$500$1K$2K$5Kfacility $3,090professional $355

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
$1,737.80
Median
$3,162.28
Typical High
$5,248.07
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$77.62
Median
$77.62
Typical High
$562.34
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$30.90
Median
$30.90
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$257.04
Typical High
$3,019.95
Avera
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$302.00
Typical High
$1,905.46
Avera
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$309.03
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$436.52
Typical High
$3,090.30
Medica
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$467.74
Typical High
$2,570.40
Medica
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$1,778.28
Typical High
$7,943.28
Midlands
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$2,398.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$1,288.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$1,288.25
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$426.58
Typical High
$2,511.89
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$346.74
Typical High
$3,019.95

Where South Dakota 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

South Dakota· 9th of 51

$3,445

$355 physician + $3,090 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.