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Upper Endoscopy With Bile Duct Stone Breakup

Utah 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?

$2,138

Typical facility fee. In Utah, July 2026.

Insurers have agreed to pay about $2,138 for this service. Most negotiated rates run $631 to $4,467.

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 $4,169 · 10th to 90th $794 to $8,318Professionalmedian $617 · 10th to 90th $468 to $832
$500$1K$2K$5K$10Kfacility $4,169professional $617

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
$794.33
Median
$3,715.35
Typical High
$8,317.64
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,748.98
Typical High
$17,782.79
Select Health
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$616.60
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,466.84
Typical High
$7,079.46

Where Utah 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.

Utah· 32nd of 50

$2,138

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.