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Pennsylvania rates for HCPCS 43250

Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps

Facilitymedian $3,631 · 10th–90th $501–$8,3180%10%10th90th$3,631Professionalmedian $339 · 10th–90th $166–$7940%20%10th90th$339$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $3,715.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $316.23 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $1,288.25 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $309.03 / $707.95
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $616.60 / $1,000.00
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $1,548.82
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $489.78 / $812.83
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $416.87 / $954.99
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $758.58 / $1,047.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $288.40 / $436.52
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $416.87 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $2,630.27 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $295.12 / $645.65