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Upper Endoscopy With Mucosal Resection

Washington rates for HCPCS 43254

A flexible scope is passed through the mouth into the esophagus, stomach and the first part of the small intestine, and an abnormal patch of the lining is lifted off the wall and removed. Fluid is usually injected underneath first so the patch rises clear of the deeper layers before it is taken. It allows flat growths or early abnormal tissue to be removed without open surgery.

Facilitymedian $1,413 · 10th–90th $363$13,4900%5%10%10th90th$1,413$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$501.19
Median
$7,079.46
Typical High
$17,782.79
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$5,011.87
Typical High
$10,232.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$870.96
Typical High
$2,454.71
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$562.34
Typical High
$2,137.96
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$512.86
Typical High
$537.03
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$363.08
Typical High
$1,230.27
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$5,248.07
Typical High
$10,232.93
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$5,495.41
Typical High
$10,715.19