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Upper Endoscopy With Bleeding Control

Washington, DC rates for HCPCS 43255

During this upper endoscopy, a flexible scope is passed through the mouth to examine the esophagus, stomach, and the first part of the small intestine, and the physician also treats an area of active or recent bleeding found during the exam. Bleeding is controlled using techniques such as cautery, clips, or injected medication delivered through the scope. Combining diagnosis and treatment in a single procedure can avoid the need for a separate follow-up intervention.

Rates data updated October 2026.

How much does Upper Endoscopy With Bleeding Control cost?

$257

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $257 for this service. Most negotiated rates run $214 to $661.

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.

How much rates vary

Facilitymedian $2,138 · 10th to 90th $501 to $16,218Professionalmedian $245 · 10th to 90th $191 to $776
$200$500$1K$2K$5K$10K$20Kfacility $2,138professional $245

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$1,949.84
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$467.74
Typical High
$776.25
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$114.82
Median
$134.90
Typical High
$389.05
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$45.71
Median
$53.70
Typical High
$154.88
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$169.82
Median
$199.53
Typical High
$575.44
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$33.88
Median
$39.81
Typical High
$114.82
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$22.91
Median
$26.92
Typical High
$77.62
CareFirst
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$213.80
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$489.78
Typical High
$660.69
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$758.58
Typical High
$1,479.11
United
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$2,511.89
Typical High
$27,542.29
United
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$407.38
Typical High
$1,174.90

Where Washington, DC sits

The same service costs 4.2 times more in Alaska than in Washington, DC. 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.

Washington, DC· 51st of 51

$257

AK $1,072DC $257

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.