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Upper Endoscopy With Bile Duct Stone Breakup

Indiana 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?

$10,965

Typical facility fee. In Indiana, July 2026.

Insurers have agreed to pay about $10,965 for this service. Most negotiated rates run $3,715 to $19,953.

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 $10,965 · 10th to 90th $724 to $24,547
$500$1K$2K$5K$10K$20Kfacility $10,965

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
$616.60
Median
$2,818.38
Typical High
$15,135.61
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$15,488.17
Typical High
$25,703.96
CareSource
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$426.58
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$676.08
Typical High
$3,630.78
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$5,370.32
Typical High
$10,715.19

Where Indiana 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.

Indiana· 2nd of 50

$10,965

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.