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Upper Endoscopy With Growth Removal By Cautery

North Carolina 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?

$796

Typical total for the visit. In North Carolina, July 2026.

Insurers have agreed to pay about $796 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $457 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$339$245 to $550
Facility feeThe hospital or surgery center$457$234 to $692

How much rates vary

Facilitymedian $457 · 10th to 90th $170 to $3,090Professionalmedian $339 · 10th to 90th $178 to $977
$200$500$1K$2K$5Kfacility $457professional $339

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
$269.15
Median
$1,288.25
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$363.08
Typical High
$812.83
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$331.13
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$851.14
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$363.08
Typical High
$870.96
Medcost
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Medcost
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$707.95
Medcost
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$1,122.02
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,995.26
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$269.15
Typical High
$645.65
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$28,840.32
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,715.35

Where North Carolina 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

North Carolina· 48th of 51

$796

$339 physician + $457 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.