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Upper Endoscopy With Bile Duct Stone Breakup

Texas 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?

$2,754

Typical facility fee. In Texas, July 2026.

Insurers have agreed to pay about $2,754 for this service. Most negotiated rates run $851 to $5,623.

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 $2,754 · 10th to 90th $513 to $12,303
$500$1K$2K$5K$10K$20Kfacility $2,754

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
$3,162.28
Typical High
$12,022.64
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$7,585.78
Typical High
$14,125.38
Christus
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$6,456.54
Typical High
$6,456.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$2,187.76
Typical High
$3,890.45
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$28,840.32
Typical High
$28,840.32
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$645.65
Typical High
$1,071.52
Providence
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$645.65
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$3,981.07
Typical High
$7,762.47

Where Texas 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.

Texas· 26th of 50

$2,754

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.