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Upper Endoscopy With Growth Removal By Cautery

Virginia 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?

$796

Typical total for the visit. In Virginia, July 2026.

Insurers have agreed to pay about $796 for this procedure. That total is two separate charges: $339 to the doctor who performs it, and $457 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$339$195 to $525
Facility feeThe hospital or surgery center$457$219 to $2,754

How much rates vary

Facilitymedian $457 · 10th to 90th $191 to $5,888Professionalmedian $339 · 10th to 90th $166 to $708
$200$500$1K$2K$5K$10Kfacility $457professional $339

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
$194.98
Median
$3,235.94
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$275.42
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,981.07
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$407.38
Typical High
$741.31
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$181.97
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$794.33
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$323.59
Typical High
$741.31
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$588.84
Typical High
$1,000.00
Medcost
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$269.15
Typical High
$660.69
Medcost
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$331.13
Typical High
$758.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$389.05
Sentara
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$831.76
Sentara
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$512.86
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$2,884.03
Typical High
$5,754.40
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$288.40
Typical High
$691.83

Where Virginia 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

Virginia· 47th of 51

$796

$339 physician + $457 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.