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Upper Endoscopy With Growth Removal By Cautery

Kentucky 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?

$2,633

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

Insurers have agreed to pay about $2,633 for this procedure. That total is two separate charges: $234 to the doctor who performs it, and $2,399 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$234$178 to $427
Facility feeThe hospital or surgery center$2,399$1,413 to $4,365

How much rates vary

Facilitymedian $2,399 · 10th to 90th $537 to $5,495Professionalmedian $234 · 10th to 90th $162 to $550
$200$500$1K$2K$5Kfacility $2,399professional $234

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
$208.93
Median
$794.33
Typical High
$5,495.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$245.47
Typical High
$549.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$2,884.03
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$190.55
Typical High
$436.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$251.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$389.05
Typical High
$2,398.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,445.44
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$281.84
Typical High
$616.60

Where Kentucky 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

Kentucky· 21st of 51

$2,633

$234 physician + $2,399 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.