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Upper Endoscopy With Bile Duct Stone Breakup

Maine 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 rates vary

Facilitymedian $617 · 10th to 90th $617 to $12,303
$1K$2K$5K$10Kfacility $617

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
Cigna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$12,302.69
Median
$12,302.69
Typical High
$12,302.69