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Duct Stone Removal By Scope, Bile Or Pancreas

Vermont 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 October 2026.

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

$6,112

Typical total for the visit. In Vermont, October 2026.

Insurers have agreed to pay about $6,112 for this procedure. That total is two separate charges: $617 to the doctor who performs it, and $5,495 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$617$513 to $631
Facility feeThe hospital or surgery center$5,495$4,467 to $5,495

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,698 to $5,495Professionalmedian $617 · 10th to 90th $427 to $741
$500$1K$2K$5Kfacility $5,495professional $617

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$5,495.41
Aetna
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$562.34
Typical High
$707.95
BCBS Vermont
Setting
Facility
Modifier
None
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$4,466.84
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$630.96
Typical High
$630.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$4,466.84
Cigna
Setting
Professional
Modifier
None
Typical Low
$524.81
Median
$616.60
Typical High
$660.69
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$380.19
Median
$537.03
Typical High
$933.25
United
Setting
Facility
Modifier
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
United
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$512.86
Typical High
$741.31

Where Vermont sits

The same service costs 5.5 times more in Colorado than in Montana. 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.

Physician feeFacility fee

Vermont· 2nd of 51

$6,112

$617 physician + $5,495 facility

CO $6,136MT $1,125

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.