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Scope Procedure With Widening the Duct Opening

California rates for HCPCS 43262

A flexible scope is passed through the mouth to the point where the bile and pancreas ducts drain into the small intestine, and the muscular valve at that opening is cut to widen it. Widening the opening lets trapped stones pass, relieves blockage and gives access for further work inside the ducts. It is done under sedation, with no cut in the abdomen.

Rates data updated July 2026.

How much does Scope Procedure With Widening the Duct Opening cost?

$5,248

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $5,248 for this service. Most negotiated rates run $2,818 to $8,128.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,623 · 10th to 90th $933 to $13,804Professionalmedian $372 · 10th to 90th $288 to $676
$100$500$2K$10Kfacility $5,623professional $372

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
$1,230.27
Median
$5,370.32
Typical High
$16,595.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$6,025.60
Typical High
$13,489.63
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$4,265.80
Typical High
$8,912.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$1,023.29
Typical High
$4,786.30
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$371.54
Typical High
$562.34
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$354.81
Typical High
$707.95
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$11,220.18
Typical High
$28,840.32
Providence
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$501.19
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$7,079.46
Typical High
$15,135.61

Where California sits

The same service costs 22.4 times more in Indiana than in Delaware. 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.

California· 5th of 51

$5,248

IN $7,943DE $355

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.