Insertion of stomach tube using a flexible endoscope
Medicare pricing data for 13,121 providers across 52 states
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
Insertion of stomach tube using a flexible endoscope (HCPCS code 43246) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $187.52, but hospitals typically charge $931.70 — 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 $187.52, your out-of-pocket cost would be approximately $37.50. 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 $148.45 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $250 | $2,900 | 28 | 41 | +33.5% |
| Wyoming | $228 | $1,133 | 27 | 49 | +21.5% |
| Louisiana | $208 | $866 | 261 | 1,275 | +10.9% |
| New York | $206 | $1,187 | 844 | 3,795 | +9.7% |
| California | $204 | $939 | 998 | 6,212 | +9.0% |
| Florida | $201 | $716 | 968 | 4,477 | +7.4% |
| Maryland | $196 | $830 | 256 | 1,105 | +4.7% |
| District of Columbia | $196 | $745 | 53 | 231 | +4.5% |
| Nevada | $196 | $648 | 98 | 469 | +4.5% |
| Illinois | $195 | $1,261 | 542 | 2,174 | +4.1% |
| Connecticut | $189 | $1,208 | 139 | 299 | +1.0% |
| Rhode Island | $188 | $831 | 48 | 127 | +0.3% |
| Michigan | $187 | $620 | 409 | 1,506 | -0.1% |
| Texas | $187 | $855 | 949 | 3,986 | -0.3% |
| Hawaii | $185 | $605 | 28 | 47 | -1.5% |
| Puerto Rico | $184 | $340 | 36 | 66 | -2.1% |
| Massachusetts | $183 | $963 | 283 | 820 | -2.1% |
| New Hampshire | $183 | $1,994 | 65 | 173 | -2.6% |
| New Jersey | $180 | $1,452 | 459 | 2,046 | -3.8% |
| Tennessee | $180 | $819 | 314 | 1,249 | -4.1% |
| Pennsylvania | $179 | $969 | 686 | 1,715 | -4.5% |
| Virginia | $179 | $706 | 312 | 890 | -4.6% |
| Georgia | $179 | $865 | 403 | 1,251 | -4.6% |
| Washington | $179 | $686 | 176 | 403 | -4.7% |
| Colorado | $177 | $768 | 170 | 324 | -5.5% |
| Kentucky | $176 | $682 | 290 | 1,095 | -6.0% |
| Alabama | $176 | $844 | 238 | 1,031 | -6.0% |
| Delaware | $176 | $740 | 39 | 114 | -6.3% |
| New Mexico | $175 | $775 | 48 | 88 | -6.6% |
| Oklahoma | $175 | $734 | 176 | 760 | -6.8% |
| Maine | $174 | $763 | 60 | 100 | -7.0% |
| Montana | $174 | $698 | 41 | 86 | -7.2% |
| Ohio | $174 | $849 | 698 | 2,414 | -7.4% |
| Missouri | $173 | $794 | 336 | 1,039 | -7.6% |
| Mississippi | $173 | $942 | 152 | 955 | -7.6% |
| North Carolina | $173 | $907 | 392 | 941 | -8.0% |
| West Virginia | $173 | $794 | 120 | 403 | -8.0% |
| Arkansas | $172 | $843 | 133 | 728 | -8.1% |
| Vermont | $172 | $1,024 | 21 | 38 | -8.1% |
| Oregon | $172 | $683 | 135 | 250 | -8.1% |
| Minnesota | $172 | $1,161 | 139 | 316 | -8.5% |
| Kansas | $171 | $803 | 139 | 417 | -9.0% |
| Arizona | $171 | $682 | 182 | 542 | -9.1% |
| Iowa | $169 | $1,161 | 92 | 241 | -9.7% |
| Wisconsin | $169 | $2,262 | 256 | 504 | -9.7% |
| Indiana | $169 | $821 | 304 | 1,182 | -9.8% |
| Utah | $168 | $696 | 58 | 121 | -10.2% |
| South Carolina | $167 | $1,212 | 251 | 829 | -11.1% |
| North Dakota | $161 | $964 | 35 | 80 | -14.4% |
| Nebraska | $159 | $855 | 78 | 183 | -15.1% |
| Idaho | $153 | $602 | 60 | 101 | -18.5% |
| South Dakota | $151 | $1,023 | 38 | 119 | -19.5% |
⚠️ 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