Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope
Medicare pricing data for 1,590 providers across 49 states
Prices vary significantly by location — from $186 in Arkansas to $765 in Alaska. 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 guided needle aspiration or biopsy of esophagus using a flexible endoscope (HCPCS code 43238) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $223.63, but hospitals typically charge $1,115 — a 5.0x 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 $223.63, your out-of-pocket cost would be approximately $44.73. 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 5.0x more than what Medicare allows for this procedure. Medicare actually pays $175.18 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $765 | $9,106 | 3 | 16 | +241.9% |
| Wyoming | $378 | $2,657 | 2 | 20 | +69.2% |
| Louisiana | $333 | $1,399 | 19 | 361 | +48.9% |
| Kansas | $303 | $2,112 | 13 | 214 | +35.5% |
| Maryland | $266 | $771 | 23 | 284 | +19.1% |
| New Jersey | $256 | $1,483 | 57 | 729 | +14.4% |
| Florida | $250 | $937 | 110 | 1,001 | +11.9% |
| Texas | $240 | $1,507 | 108 | 1,080 | +7.5% |
| New York | $237 | $1,535 | 130 | 1,312 | +5.9% |
| District of Columbia | $236 | $638 | 11 | 122 | +5.4% |
| Ohio | $230 | $1,123 | 73 | 665 | +2.8% |
| California | $226 | $916 | 99 | 1,220 | +0.9% |
| Michigan | $225 | $789 | 51 | 442 | +0.7% |
| Connecticut | $224 | $996 | 26 | 119 | +0.1% |
| Nevada | $222 | $960 | 8 | 41 | -0.7% |
| Massachusetts | $219 | $1,079 | 48 | 519 | -2.2% |
| Illinois | $218 | $1,302 | 70 | 727 | -2.4% |
| New Mexico | $216 | $723 | 4 | 34 | -3.4% |
| Maine | $214 | $904 | 6 | 53 | -4.1% |
| Wisconsin | $214 | $1,757 | 39 | 486 | -4.4% |
| Pennsylvania | $213 | $1,053 | 101 | 1,038 | -4.6% |
| Montana | $213 | $709 | 7 | 37 | -4.7% |
| Utah | $210 | $706 | 8 | 86 | -6.0% |
| Virginia | $208 | $817 | 48 | 373 | -7.0% |
| Colorado | $207 | $621 | 26 | 268 | -7.4% |
| West Virginia | $207 | $1,091 | 9 | 79 | -7.5% |
| Georgia | $207 | $1,000 | 41 | 264 | -7.5% |
| Washington | $205 | $713 | 39 | 439 | -8.2% |
| North Carolina | $204 | $1,004 | 41 | 422 | -8.9% |
| Oklahoma | $203 | $1,267 | 12 | 223 | -9.3% |
| Alabama | $200 | $1,099 | 22 | 185 | -10.5% |
| Indiana | $200 | $851 | 56 | 585 | -10.8% |
| Minnesota | $199 | $1,161 | 38 | 403 | -10.9% |
| Tennessee | $199 | $934 | 22 | 284 | -11.1% |
| Missouri | $198 | $815 | 48 | 541 | -11.3% |
| Nebraska | $198 | $829 | 13 | 281 | -11.3% |
| Oregon | $198 | $713 | 14 | 144 | -11.6% |
| Idaho | $197 | $435 | 4 | 43 | -11.8% |
| Kentucky | $196 | $745 | 15 | 141 | -12.6% |
| Iowa | $195 | $1,148 | 10 | 54 | -13.0% |
| Delaware | $194 | $496 | 7 | 68 | -13.5% |
| New Hampshire | $193 | $2,417 | 8 | 111 | -13.6% |
| Mississippi | $193 | $729 | 6 | 34 | -13.7% |
| North Dakota | $192 | $734 | 4 | 132 | -14.1% |
| South Carolina | $190 | $701 | 18 | 177 | -15.2% |
| Arizona | $189 | $907 | 38 | 532 | -15.3% |
| Vermont | $189 | $1,329 | 4 | 48 | -15.7% |
| South Dakota | $189 | $653 | 6 | 134 | -15.7% |
| Arkansas | $186 | $807 | 11 | 116 | -17.0% |
⚠️ 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