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Upper Endoscopy With Bile Duct Stone Breakup

Washington 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?

$1,230

Typical facility fee. In Washington, July 2026.

Insurers have agreed to pay about $1,230 for this service. Most negotiated rates run $832 to $7,413.

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 $1,230 · 10th to 90th $617 to $17,783
$500$1K$2K$5K$10K$20Kfacility $1,230

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
$691.83
Median
$4,677.35
Typical High
$17,782.79
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$18,197.01
Typical High
$30,902.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$741.31
Typical High
$7,762.47
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,000.00
Typical High
$7,244.36
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$831.76
Typical High
$891.25
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$588.84
Typical High
$3,715.35
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$16,982.44
Typical High
$30,902.95
United
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$17,378.01
Typical High
$33,884.42

Where Washington 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.

Washington· 37th of 50

$1,230

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.