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Upper Endoscopy With Bile Duct Stone Breakup

Tennessee 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?

$2,818

Typical facility fee. In Tennessee, July 2026.

Insurers have agreed to pay about $2,818 for this service. Most negotiated rates run $1,820 to $5,129.

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 $2,818 · 10th to 90th $813 to $9,120
$1K$2K$5K$10K$20Kfacility $2,818

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
$707.95
Median
$2,290.87
Typical High
$5,128.61
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$6,165.95
Typical High
$9,772.37
Cigna
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$2,187.76
Typical High
$5,754.40
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$28,840.32
Typical High
$28,840.32
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$3,311.31
Typical High
$6,025.60

Where Tennessee 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.

Tennessee· 25th of 50

$2,818

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.