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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.

Facilitymedian $468 · 10th–90th $182$3,0900%5%10th90th$468Professionalmedian $389 · 10th–90th $155$9550%5%10%10th90th$389$200.0$500.0$1.0K$2.0K

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
$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