go back

Upper Endoscopy With Bile Duct Stone Breakup

Colorado rates for HCPCS 43265

A flexible scope is passed through the mouth to the opening of the bile and pancreatic ducts, and a stone that is too large or too wedged to pull out whole is broken into pieces first. The fragments are then removed or allowed to pass. Dye and X-ray pictures are used to find the stone and confirm the duct is clear.

Rates data updated July 2026.

How much does Upper Endoscopy With Bile Duct Stone Breakup cost?

$5,495

Typical facility fee. In Colorado, July 2026.

Insurers have agreed to pay about $5,495 for this service. Most negotiated rates run $1,096 to $10,965.

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 $5,495 · 10th to 90th $537 to $16,596Professionalmedian $537 · 10th to 90th $380 to $2,344
$500$1K$2K$5K$10K$20Kfacility $5,495professional $537

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. 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
Global
Typical Low
$1,445.44
Median
$3,388.44
Typical High
$7,585.78
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$11,481.54
Typical High
$19,498.45
Cigna
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,096.48
Typical High
$2,187.76
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$645.65
Typical High
$1,047.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$537.03
Typical High
$2,344.23
Select Health
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$707.95
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$4,897.79
Typical High
$10,471.29

Where Colorado sits

The same service costs 72.4 times more in West Virginia than in North Dakota. 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.

Colorado· 7th of 50

$5,495

WV $31,623ND $437

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.