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Upper Endoscopy With Growth Removal By Cautery

West 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?

$1,075

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

Insurers have agreed to pay about $1,075 for this procedure. That total is two separate charges: $204 to the doctor who performs it, and $871 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$204$178 to $437
Facility feeThe hospital or surgery center$871$269 to $2,138

How much rates vary

Facilitymedian $871 · 10th to 90th $170 to $2,138Professionalmedian $204 · 10th to 90th $158 to $550
$200$500$1K$2K$5Kfacility $871professional $204

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
$1,096.48
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$549.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$218.78
CareSource
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$416.87
Typical High
$2,398.83
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$8,317.64
Typical High
$8,317.64
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$1,230.27
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$245.47
Typical High
$501.19

Where West 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

West Virginia· 38th of 51

$1,075

$204 physician + $871 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.