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Duct Stone Removal By Scope, Bile Or Pancreas

California rates for HCPCS 43264

A flexible scope is passed through the mouth down to the point where the bile and pancreatic ducts drain into the small intestine, and stones or debris are pulled out of the duct with a balloon or a wire basket. Either duct can be cleared this way. Dye and X-ray pictures guide the work from inside, so nothing is done through a cut in the abdomen, and it relieves the blockage causing jaundice, pain or infection.

Facilitymedian $5,623 · 10th–90th $1,175$13,8040%10%10th90th$5,623Professionalmedian $372 · 10th–90th $295$9120%20%40%10th90th$372$1.0$5.0$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
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$5,248.07
Typical High
$15,135.61
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$6,165.95
Typical High
$13,489.63
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$4,466.84
Typical High
$9,332.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$1,023.29
Typical High
$5,248.07
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$380.19
Typical High
$575.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$363.08
Typical High
$977.24
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
$354.81
Median
$537.03
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$7,079.46
Typical High
$14,454.40