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South Dakota 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
$212.98 / $212.98 / $3,511.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.08 / $421.86 / $695.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.40 / $605.85 / $5,595.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.08 / $389.80 / $444.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00