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Upper Endoscopy With Growth Removal By Cautery

Michigan 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?

$3,135

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

Insurers have agreed to pay about $3,135 for this procedure. That total is two separate charges: $251 to the doctor who performs it, and $2,884 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$251$178 to $468
Facility feeThe hospital or surgery center$2,884$1,000 to $4,898

How much rates vary

Facilitymedian $2,884 · 10th to 90th $490 to $4,898Professionalmedian $251 · 10th to 90th $162 to $562
$50$100$200$500$1K$2K$5Kfacility $2,884professional $251

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
$562.34
Median
$2,884.03
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$562.34
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$245.47
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$354.81
Typical High
$831.76
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$575.44
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$323.59
Typical High
$630.96
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$645.65
Typical High
$1,778.28
United
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$2,951.21
Typical High
$6,165.95
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$295.12
Typical High
$660.69

Where Michigan 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

Michigan· 16th of 51

$3,135

$251 physician + $2,884 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.