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Pennsylvania rates for HCPCS 43253

Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $4,265.80 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $4,466.84 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,230.27 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$354.81 / $354.81 / $354.81
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $5,128.61 / $9,772.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $3,801.89 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $524.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $302.00 / $302.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $2,398.83 / $6,025.60