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Upper Endoscopy With Growth Removal By Cautery

Utah 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 $3,890 · 10th–90th $257$8,5110%10%10th90th$3,890Professionalmedian $282 · 10th–90th $170$9120%10%10th90th$282$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$257.04
Median
$4,168.69
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$354.81
Typical High
$776.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$524.81
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$3,715.35
Typical High
$5,623.41
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$389.05
Typical High
$831.76
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Select Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$398.11
Typical High
$1,230.27
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$562.34
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$3,890.45
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$309.03
Typical High
$645.65