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Virginia rates for HCPCS 43278

Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed

Facilitymedian $832 · 10th–90th $468–$7,9430%5%10%10th90th$832Professionalmedian $447 · 10th–90th $363–$9770%20%10th90th$447$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $3,630.78 / $8,317.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $6,760.83 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,698.24 / $2,089.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $724.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $977.24 / $977.24
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $549.54 / $870.96
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $575.44 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $5,495.41 / $12,882.50