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Upper Endoscopy With Bile Duct Stone Breakup

Kentucky 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?

$2,455

Typical facility fee. In Kentucky, July 2026.

Insurers have agreed to pay about $2,455 for this service. Most negotiated rates run $1,585 to $4,365.

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 $2,455 · 10th to 90th $676 to $8,913
$500$1K$2K$5K$10Kfacility $2,455

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
$524.81
Median
$1,288.25
Typical High
$8,511.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,818.38
Typical High
$9,120.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$457.09
Typical High
$630.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$1,659.59
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
$575.44
Median
$3,388.44
Typical High
$6,025.60

Where Kentucky 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.

Kentucky· 29th of 50

$2,455

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.