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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
$316.00 / $2,938.00 / $7,799.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$129.32 / $135.77 / $135.77
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,736.00 / $4,444.00 / $15,949.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.00 / $1,235.59 / $2,760.00
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$230.55 / $230.55 / $230.55
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.91 / $569.91 / $569.91
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,151.97 / $5,151.97 / $10,644.98
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.00 / $3,839.00 / $8,017.00
Martin's Point
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$135.77 / $135.77 / $135.77
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.80 / $296.80 / $296.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.83 / $1,225.90 / $3,025.00
Priority Health
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$230.55 / $230.55 / $230.55
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.69 / $253.69 / $301.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.00 / $1,734.00 / $4,300.00