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Upper Endoscopy With Growth Removal By Cautery

Maine 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?

$951

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

Insurers have agreed to pay about $951 for this procedure. That total is two separate charges: $427 to the doctor who performs it, and $525 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$427$204 to $617
Facility feeThe hospital or surgery center$525$204 to $589

How much rates vary

Facilitymedian $525 · 10th to 90th $178 to $3,890Professionalmedian $427 · 10th to 90th $186 to $1,072
$200$500$1K$2Kfacility $525professional $427

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
$177.83
Median
$524.81
Typical High
$3,890.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$524.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$398.11
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$398.11
Typical High
$977.24
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$537.03
Typical High
$1,258.93
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$524.81
Typical High
$3,890.45
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$436.52
Typical High
$1,000.00

Where Maine 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

Maine· 42nd of 51

$951

$427 physician + $525 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.