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Upper Endoscopy With Bile Duct Stone Breakup

Iowa 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?

$2,188

Typical facility fee. In Iowa, July 2026.

Insurers have agreed to pay about $2,188 for this service. Most negotiated rates run $871 to $5,012.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,388 · 10th to 90th $724 to $12,303Professionalmedian $1,023 · 10th to 90th $407 to $2,239
$500$1K$2K$5K$10Kfacility $3,388professional $1,023

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
$812.83
Median
$4,265.80
Typical High
$7,943.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$977.24
Typical High
$2,290.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,000.00
Typical High
$14,454.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,023.29
Typical High
$1,288.25
Midlands
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$7,413.10
Typical High
$15,848.93

Where Iowa 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.

Iowa· 30th of 50

$2,188

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.