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Upper Endoscopy With Growth Removal By Cautery

South Dakota 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?

$857

Typical total for the visit. In South Dakota, July 2026.

Insurers have agreed to pay about $857 for this procedure. That total is two separate charges: $389 to the doctor who performs it, and $468 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$389$234 to $676
Facility feeThe hospital or surgery center$468$263 to $1,072

How much rates vary

Facilitymedian $468 · 10th to 90th $182 to $3,090Professionalmedian $389 · 10th to 90th $155 to $955
$200$500$1K$2Kfacility $468professional $389

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
$169.82
Median
$3,090.30
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$213.80
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$478.63
Typical High
$1,318.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$407.38
Typical High
$1,174.90
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$707.95
Typical High
$3,311.31
Midlands
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$416.87
Typical High
$933.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$549.54
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$512.86
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$446.68
Typical High
$1,047.13
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$389.05
Typical High
$1,258.93

Where South Dakota 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

South Dakota· 46th of 51

$857

$389 physician + $468 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.