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Upper Endoscopy With Bile Duct Stone Breakup

Nebraska 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?

$4,365

Typical facility fee. In Nebraska, July 2026.

Insurers have agreed to pay about $4,365 for this service. Most negotiated rates run $1,318 to $8,511.

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 $5,012 · 10th to 90th $692 to $13,490Professionalmedian $1,023 · 10th to 90th $832 to $1,349
$500$1K$2K$5K$10K$20Kfacility $5,012professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$6,025.60
Typical High
$14,454.40
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$10,000.00
Typical High
$19,498.45
Medica
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$707.95
Typical High
$7,413.10
Midlands
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,023.29
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$5,623.41
Typical High
$9,120.11

Where Nebraska 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.

Nebraska· 12th of 50

$4,365

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.