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Upper Endoscopy With Bleeding Control

South Carolina 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 July 2026.

How much does Upper Endoscopy With Bleeding Control cost?

$1,193

Typical total for the visit. In South Carolina, July 2026.

Insurers have agreed to pay about $1,193 for this procedure. That total is two separate charges: $380 to the doctor who performs it, and $813 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$380$234 to $724
Facility feeThe hospital or surgery center$813$372 to $2,239

How much rates vary

Facilitymedian $813 · 10th to 90th $234 to $9,333Professionalmedian $380 · 10th to 90th $191 to $1,023
$50$200$1K$5K$20Kfacility $813professional $380

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
$234.42
Median
$1,412.54
Typical High
$9,772.37
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$117.49
Median
$281.84
Typical High
$870.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$363.08
Typical High
$1,023.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$190.55
Typical High
$288.40
BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,584.89
Typical High
$3,630.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$562.34
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$575.44
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$436.52
Typical High
$1,318.26
Medcost
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$389.05
Typical High
$457.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$436.52
Typical High
$1,071.52
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$5,888.44
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$398.11
Typical High
$812.83

Where South Carolina sits

The same service costs 7.4 times more in New Jersey 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

South Carolina· 44th of 50

$1,193

$380 physician + $813 facility

NJ $6,191MT $832

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.