Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Medicare pricing data for 5,666 providers across 50 states
This procedure has a 14.6x markup — hospitals charge $1,009 but Medicare allows only $69.13. Uninsured patients may face bills 14.6 times higher than what insurance negotiates. Prices vary significantly by location — from $48 in West Virginia to $103 in District of Columbia. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS code 43236) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $69.13, but hospitals typically charge $1,009 — a 14.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $69.13, your out-of-pocket cost would be approximately $13.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 14.6x more than what Medicare allows for this procedure. Medicare actually pays $54.04 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $103 | $649 | 18 | 37 | +49.6% |
| Iowa | $101 | $1,061 | 44 | 106 | +46.5% |
| Oregon | $98 | $1,178 | 59 | 95 | +41.2% |
| Alaska | $94 | $2,155 | 13 | 42 | +35.8% |
| Nevada | $84 | $1,060 | 33 | 64 | +22.0% |
| Maryland | $84 | $849 | 104 | 243 | +21.5% |
| Massachusetts | $82 | $921 | 152 | 311 | +18.9% |
| Colorado | $79 | $1,098 | 95 | 259 | +13.7% |
| Mississippi | $78 | $1,061 | 66 | 174 | +13.5% |
| Arkansas | $78 | $799 | 48 | 105 | +12.5% |
| Tennessee | $77 | $945 | 126 | 289 | +11.5% |
| Indiana | $76 | $1,015 | 121 | 269 | +9.4% |
| Ohio | $76 | $776 | 207 | 427 | +9.4% |
| Missouri | $75 | $804 | 136 | 335 | +9.1% |
| California | $75 | $1,346 | 477 | 1,271 | +8.5% |
| Michigan | $74 | $653 | 180 | 410 | +7.7% |
| New York | $74 | $1,514 | 288 | 636 | +6.6% |
| Delaware | $73 | $712 | 26 | 80 | +5.9% |
| Louisiana | $73 | $764 | 94 | 252 | +5.6% |
| New Jersey | $72 | $1,446 | 206 | 423 | +4.8% |
| Kansas | $72 | $652 | 55 | 172 | +4.6% |
| Arizona | $70 | $742 | 106 | 328 | +1.9% |
| Pennsylvania | $70 | $754 | 329 | 835 | +0.9% |
| South Dakota | $69 | $851 | 20 | 37 | -0.1% |
| Rhode Island | $69 | $901 | 23 | 56 | -0.4% |
| Oklahoma | $69 | $656 | 62 | 146 | -0.5% |
| Florida | $68 | $866 | 454 | 1,232 | -1.8% |
| Montana | $67 | $501 | 18 | 90 | -3.1% |
| North Carolina | $66 | $920 | 196 | 389 | -4.9% |
| Texas | $66 | $1,149 | 439 | 1,117 | -5.2% |
| Utah | $65 | $771 | 39 | 109 | -5.3% |
| Nebraska | $65 | $963 | 30 | 73 | -6.1% |
| Idaho | $64 | $502 | 40 | 77 | -7.8% |
| Kentucky | $63 | $683 | 83 | 246 | -8.2% |
| New Mexico | $63 | $663 | 23 | 48 | -8.6% |
| Minnesota | $62 | $1,000 | 103 | 221 | -9.7% |
| Virginia | $61 | $843 | 150 | 339 | -11.6% |
| Wisconsin | $60 | $2,570 | 116 | 206 | -13.3% |
| North Dakota | $59 | $978 | 11 | 30 | -14.3% |
| Hawaii | $58 | $1,038 | 11 | 23 | -16.1% |
| Georgia | $58 | $855 | 164 | 365 | -16.4% |
| Connecticut | $57 | $989 | 69 | 125 | -18.2% |
| South Carolina | $56 | $869 | 106 | 334 | -18.6% |
| Vermont | $56 | $1,250 | 8 | 11 | -18.7% |
| Alabama | $55 | $674 | 93 | 226 | -21.0% |
| New Hampshire | $54 | $2,312 | 30 | 55 | -21.2% |
| Illinois | $52 | $1,183 | 221 | 624 | -24.4% |
| Maine | $52 | $540 | 28 | 48 | -24.9% |
| Washington | $52 | $805 | 114 | 250 | -25.4% |
| West Virginia | $48 | $682 | 22 | 67 | -30.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber