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Upper Endoscopy With Growth Removal By Cautery

Connecticut 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 October 2026.

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

$3,937

Typical total for the visit. In Connecticut, October 2026.

Insurers have agreed to pay about $3,937 for this procedure. That total is two separate charges: $389 to the doctor who performs it, and $3,548 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$389$275 to $759
Facility feeThe hospital or surgery center$3,548$1,995 to $4,898

How much rates vary

Facilitymedian $3,548 · 10th to 90th $851 to $6,607Professionalmedian $389 · 10th to 90th $214 to $1,230
$200$500$1K$2K$5K$10Kfacility $3,548professional $389

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2,754.23
Median
$4,897.79
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$263.03
Typical High
$588.84
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$2,754.23
Median
$3,715.35
Typical High
$6,025.60
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$426.58
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$1,905.46
Typical High
$2,454.71
Cigna
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$302.00
Typical High
$794.33
ConnectiCare
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$602.56
Typical High
$758.58
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$295.12
Typical High
$831.76
United
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$2,691.53
Typical High
$6,918.31
United
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$426.58
Typical High
$1,047.13
5 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$97.72
Median
$128.82
Typical High
$295.12
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$38.90
Median
$51.29
Typical High
$117.49
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$144.54
Median
$190.55
Typical High
$446.68
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$28.84
Median
$38.02
Typical High
$89.13
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.50
Median
$25.70
Typical High
$58.88

Where Connecticut sits

The same service costs 5.4 times more in Colorado than in West Virginia. 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

Connecticut· 2nd of 51

$3,937

$389 physician + $3,548 facility

CO $4,173WV $767

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.