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Wisconsin rates for HCPCS 43255

Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method

Facilitymedian $3,890 · 10th–90th $407–$7,0790%5%10%10th90th$3,890Professionalmedian $575 · 10th–90th $195–$1,5140%5%10%10th90th$575$20.0$100.0$500.0$2.0K$10.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $3,388.44 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $467.74 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,570.88 / $7,079.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $794.33 / $2,290.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $346.74
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $549.54 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,995.26 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $794.33 / $2,630.27
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $630.96 / $3,311.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $851.14 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $676.08 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $1,288.25 / $4,570.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $3,890.45 / $4,570.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $891.25 / $2,398.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $851.14 / $2,290.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $4,897.79 / $4,897.79
Quartz
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Quartz
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$269.15 / $2,630.27 / $3,890.45
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $1,318.26 / $4,365.16
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $2,454.71
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $630.96 / $2,137.96