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Upper Endoscopy With Growth Removal By Cautery

Hawaii 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.

Facilitymedian $3,890 · 10th–90th $1,096$3,8900%50%10th$3,890Professionalmedian $468 · 10th–90th $170$4,8980%10%10th90th$468$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$3,890.45
Typical High
$3,890.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$257.04
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$478.63
Typical High
$1,000.00
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$549.54
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$275.42
Typical High
$602.56
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$2,089.30
Typical High
$5,370.32