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Upper GI Endoscopy With Esophageal Balloon Dilation

West Virginia 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?

$1,266

Typical total for the visit. In West Virginia, July 2026.

Insurers have agreed to pay about $1,266 for this procedure. That total is two separate charges: $219 to the doctor who performs it, and $1,047 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$219$148 to $331
Facility feeThe hospital or surgery center$1,047$794 to $2,138

How much rates vary

Facilitymedian $1,047 · 10th to 90th $214 to $6,761Professionalmedian $219 · 10th to 90th $66 to $1,148
$50$200$1K$5Kfacility $1,047professional $219

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
$213.80
Median
$1,047.13
Typical High
$6,760.83
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$75.86
Median
$107.15
Typical High
$524.81
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$30.20
Median
$43.65
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$218.78
Typical High
$1,047.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$162.18
Typical High
$199.53
CareSource
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$933.25
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
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
$741.31
Typical High
$5,754.40
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$6,165.95
Typical High
$10,471.29
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$194.98
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$1,230.27
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$229.09
Typical High
$1,174.90

Where West Virginia 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

West Virginia· 49th of 51

$1,266

$219 physician + $1,047 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.