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Scope Exam of Surgically Created Intestinal Pouch

New Mexico rates for HCPCS 44385

A diagnostic exam using a flexible scope to inspect an intestinal pouch created by earlier surgery, such as a Kock-type pouch. Collection of a specimen, when performed, is included, and the listed price applies when the exam is performed on its own.

Rates data updated July 2026.

How much does Scope Exam of Surgically Created Intestinal Pouch cost?

$486

Typical total for the visit. In New Mexico, July 2026.

Insurers have agreed to pay about $486 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $295 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$191$87.10 to $251
Facility feeThe hospital or surgery center$295$151 to $631

How much rates vary

Facilitymedian $295 · 10th to 90th $91 to $3,311Professionalmedian $191 · 10th to 90th $71 to $339
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $295professional $191

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
$104.71
Median
$380.19
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$199.53
Typical High
$302.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$3,090.30
Typical High
$5,128.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$190.55
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$223.87
Typical High
$389.05
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$295.12
Providence
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$229.09
Typical High
$457.09
Providence
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$234.42
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$3,235.94
Typical High
$4,570.88
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$204.17
Typical High
$407.38

Where New Mexico sits

The same service costs 14.5 times more in New Jersey than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeNew Mexico $486 · 46th of 51
NJ $5,328WV $366

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.