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Upper Endoscopy With Growth Removal By Cautery

Ohio 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?

$3,081

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

Insurers have agreed to pay about $3,081 for this procedure. That total is two separate charges: $263 to the doctor who performs it, and $2,818 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$263$182 to $468
Facility feeThe hospital or surgery center$2,818$1,000 to $4,571

How much rates vary

Facilitymedian $2,818 · 10th to 90th $427 to $10,233Professionalmedian $263 · 10th to 90th $162 to $646
$200$500$1K$2K$5K$10Kfacility $2,818professional $263

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
$323.59
Median
$2,951.21
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$338.84
Typical High
$691.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,630.27
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$234.42
Typical High
$512.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$177.83
Typical High
$1,096.48
CareSource
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$489.78
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$346.74
Typical High
$776.25
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$602.56
Typical High
$1,819.70
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$338.84
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$177.83
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$363.08
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$2,137.96
Typical High
$5,248.07
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$302.00
Typical High
$676.08

Where Ohio 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

Ohio· 17th of 51

$3,081

$263 physician + $2,818 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.