go back

Upper Endoscopy With Growth Removal By Cautery

California rates for HCPCS 43250

This procedure uses a thin, flexible lighted scope passed through the mouth into the esophagus, stomach, and the first part of the small intestine to remove a small growth or polyp using a heated instrument that also seals the tissue as it cuts. It is done under sedation and combines diagnosis and treatment in a single visit.

Rates data updated July 2026.

How much does Upper Endoscopy With Growth Removal By Cautery cost?

$5,587

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

Insurers have agreed to pay about $5,587 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $5,248 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 14 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$339$186 to $575
Facility feeThe hospital or surgery center$5,248$3,548 to $8,318

How much rates vary

Facilitymedian $5,248 · 10th to 90th $513 to $13,490Professionalmedian $339 · 10th to 90th $162 to $1,000
$100$500$2K$10Kfacility $5,248professional $339

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
$2,290.87
Median
$6,456.54
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$1,096.48
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$134.90
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$5,888.44
Typical High
$13,489.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$776.25
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$4,073.80
Typical High
$8,511.38
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$269.15
Typical High
$912.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$1,023.29
Typical High
$2,238.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$338.84
Typical High
$851.14
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$245.47
Typical High
$851.14
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$436.52
Typical High
$912.01
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$28,840.32
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,715.35
Typical High
$3,715.35
Molina
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$616.60
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$323.59
Typical High
$794.33
Providence
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$363.08
Typical High
$977.24
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$1,445.44
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$398.11
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$4,168.69
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$295.12
Typical High
$724.44

Where California sits

The same service costs 10.1 times more in Indiana 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

California· 3rd of 51

$5,587

$339 physician + $5,248 facility

IN $6,497MT $643

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.