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Upper Endoscopy With Bile Duct Stone Breakup

Connecticut 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?

$5,248

Typical facility fee. In Connecticut, July 2026.

Insurers have agreed to pay about $5,248 for this service. Most negotiated rates run $4,266 to $7,943.

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.

How much rates vary

Facilitymedian $5,248 · 10th to 90th $2,818 to $10,471
$1K$2K$5K$10Kfacility $5,248

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
$2,754.23
Median
$4,897.79
Typical High
$8,128.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$13,803.84
Typical High
$16,595.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$5,495.41
Typical High
$7,762.47
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$6,918.31
Typical High
$11,220.18

Where Connecticut 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.

Connecticut· 11th of 50

$5,248

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.