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Upper Endoscopy With Growth Removal By Cautery

New Jersey 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?

$6,252

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $6,252 for this procedure. That total is two separate charges: $363 to the doctor who performs it, and $5,888 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$363$178 to $513
Facility feeThe hospital or surgery center$5,888$4,266 to $7,762

How much rates vary

Facilitymedian $5,888 · 10th to 90th $646 to $10,233Professionalmedian $363 · 10th to 90th $155 to $891
$200$500$1K$2K$5K$10Kfacility $5,888professional $363

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
$549.54
Median
$5,888.44
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$323.59
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$3,630.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$371.54
Typical High
$891.25
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$426.58
Typical High
$1,000.00
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$6,309.57
Typical High
$9,549.93
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$436.52
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$4,897.79
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$269.15
Typical High
$776.25

Where New Jersey 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

New Jersey· 2nd of 51

$6,252

$363 physician + $5,888 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.