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Upper Endoscopy With Bile Duct Stone Breakup

Oregon 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?

$832

Typical facility fee. In Oregon, July 2026.

Insurers have agreed to pay about $832 for this service. Most negotiated rates run $646 to $933.

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 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $832 · 10th to 90th $447 to $1,479Professionalmedian $794 · 10th to 90th $603 to $955
$200$500$1K$2K$5K$10K$20Kfacility $832professional $794

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
$1,047.13
Median
$6,025.60
Typical High
$8,709.64
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$4,677.35
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$794.33
Typical High
$954.99
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$660.69
Typical High
$1,202.26
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$831.76
Typical High
$891.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$691.83
Typical High
$1,202.26
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$18,620.87
Typical High
$22,908.68
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$9,549.93
Typical High
$18,197.01

Where Oregon 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.

Oregon· 42nd of 50

$832

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.