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New Hampshire rates for HCPCS 43257

Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $2,398.83 / $11,481.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,677.35 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $4,265.80 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $4,265.80 / $9,549.93
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $194.98 / $281.84