Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth
Medicare pricing data for 1,710 providers across 48 states
This procedure has a 5.1x markup — hospitals charge $995.41 but Medicare allows only $196.05. Uninsured patients may face bills 5.1 times higher than what insurance negotiates. Prices vary significantly by location — from $136 in Arkansas to $358 in Louisiana. 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
Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth (HCPCS code 43237) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $196.05, but hospitals typically charge $995.41 — a 5.1x 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 $196.05, your out-of-pocket cost would be approximately $39.21. 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 5.1x more than what Medicare allows for this procedure. Medicare actually pays $152.55 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $358 | $1,423 | 19 | 632 | +82.5% |
| Alaska | $352 | $2,203 | 3 | 18 | +79.7% |
| Kansas | $281 | $1,776 | 12 | 403 | +43.2% |
| Indiana | $260 | $1,894 | 52 | 744 | +32.8% |
| Mississippi | $242 | $781 | 7 | 43 | +23.2% |
| Michigan | $241 | $718 | 62 | 570 | +22.8% |
| Iowa | $235 | $1,341 | 14 | 66 | +19.8% |
| Maryland | $233 | $708 | 23 | 524 | +18.7% |
| New Jersey | $227 | $1,493 | 66 | 701 | +15.7% |
| Florida | $215 | $832 | 132 | 1,298 | +9.8% |
| New York | $214 | $1,287 | 155 | 1,921 | +9.2% |
| Texas | $205 | $1,228 | 136 | 1,345 | +4.5% |
| California | $200 | $745 | 125 | 1,488 | +2.0% |
| District of Columbia | $193 | $548 | 13 | 166 | -1.3% |
| Nebraska | $190 | $896 | 11 | 321 | -2.9% |
| Wisconsin | $187 | $1,533 | 36 | 362 | -4.6% |
| Ohio | $184 | $965 | 70 | 687 | -6.2% |
| Connecticut | $183 | $933 | 24 | 190 | -6.8% |
| Illinois | $177 | $1,131 | 75 | 885 | -9.6% |
| Massachusetts | $172 | $903 | 47 | 715 | -12.2% |
| North Carolina | $170 | $995 | 42 | 482 | -13.5% |
| Georgia | $170 | $938 | 38 | 256 | -13.5% |
| Colorado | $169 | $553 | 23 | 280 | -13.9% |
| Montana | $168 | $593 | 7 | 45 | -14.1% |
| Vermont | $167 | $1,169 | 4 | 82 | -14.6% |
| Utah | $167 | $598 | 7 | 77 | -14.8% |
| Pennsylvania | $167 | $798 | 98 | 1,153 | -14.8% |
| West Virginia | $167 | $1,072 | 10 | 136 | -15.0% |
| Alabama | $166 | $899 | 28 | 233 | -15.5% |
| New Mexico | $166 | $628 | 5 | 55 | -15.5% |
| Washington | $164 | $617 | 40 | 472 | -16.3% |
| Minnesota | $163 | $890 | 40 | 439 | -17.0% |
| New Hampshire | $162 | $1,912 | 11 | 92 | -17.2% |
| Nevada | $162 | $575 | 8 | 145 | -17.5% |
| Maine | $161 | $677 | 4 | 36 | -17.8% |
| Virginia | $160 | $652 | 54 | 522 | -18.4% |
| Idaho | $160 | $440 | 4 | 33 | -18.5% |
| Tennessee | $157 | $747 | 30 | 284 | -19.9% |
| Missouri | $156 | $696 | 38 | 765 | -20.4% |
| Kentucky | $155 | $619 | 11 | 119 | -20.9% |
| Oklahoma | $153 | $942 | 12 | 237 | -21.9% |
| South Carolina | $151 | $619 | 17 | 228 | -23.1% |
| Oregon | $150 | $586 | 14 | 193 | -23.6% |
| Delaware | $145 | $386 | 5 | 61 | -26.3% |
| South Dakota | $143 | $497 | 5 | 141 | -27.1% |
| North Dakota | $141 | $632 | 5 | 75 | -28.2% |
| Arizona | $137 | $719 | 36 | 695 | -30.2% |
| Arkansas | $136 | $850 | 10 | 239 | -30.5% |
⚠️ 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