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Upper Endoscopy With Bile Duct Stone Breakup

West Virginia 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?

$31,623

Typical facility fee. In West Virginia, July 2026.

Insurers have agreed to pay about $31,623 for this service. Most negotiated rates run $676 to $31,623.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $31,623 · 10th to 90th $427 to $31,623
$500$1K$2K$5K$10K$20Kfacility $31,623

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
$426.58
Median
$31,622.78
Typical High
$31,622.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,951.21
Typical High
$16,982.44

Where West Virginia 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.

West Virginia· 1st of 50

$31,623

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.