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Esophageal Birth Defect Repair, Infant

Pennsylvania rates for HCPCS 43314

This service is a reconstructive operation on the esophagus - the tube connecting the throat to the stomach - to correct a birth defect, such as an abnormal connection between the esophagus and windpipe or a section of esophagus that did not form properly. It is typically performed in an infant shortly after the condition is diagnosed. The goal is to restore a normal, functioning connection between the throat and stomach.

Rates data updated July 2026.

How much does Esophageal Birth Defect Repair, Infant cost?

$3,236

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $3,236 for this service. The price depends on where it is billed: about $3,162 from a physician practice, and about $5,370 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3,162$2,884 to $3,631
FacilityA hospital or hospital-owned outpatient department$5,370$2,818 to $7,762

How much rates vary

Facilitymedian $5,370 · 10th to 90th $1,023 to $8,511Professionalmedian $3,162 · 10th to 90th $2,692 to $6,166
$500$1K$2K$5K$10K$20Kfacility $5,370professional $3,162

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
$1,412.54
Median
$5,370.32
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$3,162.28
Typical High
$6,165.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$4,365.16
Median
$4,786.30
Typical High
$4,786.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$2,089.30
Typical High
$36,307.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$3,548.13
Typical High
$6,165.95
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$6,606.93
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$4,265.80
Typical High
$5,888.44
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$2,818.38
Median
$3,235.94
Typical High
$5,128.61
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$4,786.30
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$3,090.30
Typical High
$6,309.57
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$3,467.37
Typical High
$6,456.54
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$3,019.95
Typical High
$3,019.95
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$3,090.30
Typical High
$3,162.28
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$2,344.23
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$3,311.31
Typical High
$5,623.41

Where Pennsylvania sits

The same service costs 2.2 times more in Minnesota than in Kentucky. 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.

Pennsylvania· 38th of 51

$3,236

MN $6,918KY $3,090

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.