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Upper Endoscopy With Bile Duct Stone Breakup

Montana 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?

$759

Typical facility fee. In Montana, July 2026.

Insurers have agreed to pay about $759 for this service. Most negotiated rates run $724 to $977.

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 $759 · 10th to 90th $501 to $2,344
$1$10$100$1K$10K$100Kfacility $759

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
$0.89
Median
$0.89
Typical High
$3,890.45
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$741.31
Typical High
$977.24
Providence
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$794.33
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$12,302.69

Where Montana 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.

Montana· 45th of 50

$759

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.