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Upper Endoscopy With Growth Removal By Cautery

Pennsylvania 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.

Facilitymedian $3,090 · 10th–90th $501$8,3180%10%10th90th$3,090Professionalmedian $257 · 10th–90th $166$6310%20%10th90th$257$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$3,801.89
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$239.88
Typical High
$602.56
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$112.20
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$2,691.53
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$398.11
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$1,288.25
Typical High
$2,454.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$302.00
Typical High
$707.95
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$645.65
Typical High
$1,000.00
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,288.25
Typical High
$1,548.82
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$489.78
Typical High
$794.33
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$2,818.38
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$416.87
Typical High
$891.25
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$251.19
Typical High
$426.58
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$1,412.54
Typical High
$2,951.21
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$288.40
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$2,570.40
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$295.12
Typical High
$630.96