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Duct Stone Removal By Scope, Bile Or Pancreas

Virginia 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.

Rates data updated July 2026.

How much does Duct Stone Removal By Scope, Bile Or Pancreas cost?

$871

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $871 for this service. Most negotiated rates run $525 to $3,020.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $891 · 10th to 90th $407 to $6,918Professionalmedian $437 · 10th to 90th $309 to $832
$200$500$1K$2K$5K$10Kfacility $891professional $437

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
$416.87
Median
$1,905.46
Typical High
$6,918.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$6,760.83
Typical High
$7,413.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$1,698.24
Typical High
$2,089.30
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$371.54
Typical High
$870.96
Medcost
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$831.76
Medcost
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$549.54
Typical High
$977.24
Sentara
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$562.34
Typical High
$1,737.80
United
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$5,754.40
Typical High
$13,182.57

Where Virginia sits

The same service costs 14.8 times more in Delaware than in Maryland. 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.

Virginia· 46th of 51

$871

DE $5,888MD $398

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.