Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Medicare pricing data for 1,867 providers across 51 states
Prices vary significantly by location — from $168 in Arkansas to $440 in Wyoming. 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 (HCPCS code 43259) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $229.63, but hospitals typically charge $1,085 — a 4.7x 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 $229.63, your out-of-pocket cost would be approximately $45.93. 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 4.7x more than what Medicare allows for this procedure. Medicare actually pays $179.46 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Wyoming | $440 | $2,371 | 3 | 32 | +91.6% |
| Hawaii | $405 | $2,625 | 4 | 41 | +76.5% |
| Alaska | $367 | $3,294 | 4 | 55 | +59.7% |
| New Jersey | $286 | $1,557 | 54 | 911 | +24.8% |
| New York | $283 | $1,570 | 137 | 2,038 | +23.4% |
| Mississippi | $281 | $1,141 | 6 | 211 | +22.5% |
| Arizona | $276 | $822 | 39 | 642 | +20.1% |
| Florida | $274 | $1,036 | 162 | 3,418 | +19.2% |
| North Carolina | $254 | $871 | 52 | 1,344 | +10.5% |
| Texas | $246 | $1,326 | 180 | 2,128 | +6.9% |
| Indiana | $242 | $1,334 | 37 | 516 | +5.5% |
| Louisiana | $241 | $839 | 26 | 630 | +4.9% |
| District of Columbia | $234 | $736 | 10 | 154 | +1.7% |
| Alabama | $231 | $1,004 | 25 | 629 | +0.5% |
| Maryland | $220 | $952 | 34 | 724 | -4.1% |
| Georgia | $218 | $1,152 | 40 | 530 | -5.2% |
| Minnesota | $217 | $1,065 | 34 | 695 | -5.6% |
| Connecticut | $216 | $1,204 | 25 | 334 | -5.8% |
| North Dakota | $216 | $812 | 4 | 21 | -5.9% |
| Kentucky | $216 | $835 | 23 | 309 | -6.1% |
| Rhode Island | $214 | $1,236 | 5 | 66 | -6.6% |
| Kansas | $214 | $731 | 15 | 268 | -6.7% |
| Ohio | $213 | $889 | 72 | 735 | -7.0% |
| Puerto Rico | $213 | $224 | 2 | 16 | -7.1% |
| Utah | $212 | $698 | 5 | 47 | -7.6% |
| Illinois | $212 | $1,159 | 68 | 1,065 | -7.8% |
| New Hampshire | $211 | $2,273 | 13 | 243 | -8.1% |
| Michigan | $211 | $706 | 64 | 839 | -8.3% |
| California | $209 | $1,093 | 192 | 4,231 | -8.8% |
| Montana | $209 | $628 | 7 | 127 | -9.0% |
| Tennessee | $208 | $1,060 | 22 | 440 | -9.4% |
| Massachusetts | $204 | $989 | 51 | 1,138 | -11.0% |
| Delaware | $204 | $557 | 5 | 78 | -11.3% |
| Pennsylvania | $200 | $826 | 87 | 1,257 | -12.7% |
| Virginia | $199 | $834 | 58 | 665 | -13.1% |
| Nevada | $199 | $788 | 7 | 140 | -13.5% |
| Oregon | $198 | $826 | 25 | 303 | -13.7% |
| South Carolina | $196 | $1,183 | 24 | 619 | -14.7% |
| Washington | $193 | $786 | 41 | 646 | -15.8% |
| Oklahoma | $193 | $748 | 15 | 193 | -16.0% |
| Colorado | $193 | $959 | 25 | 345 | -16.2% |
| Maine | $192 | $861 | 7 | 74 | -16.2% |
| Idaho | $192 | $549 | 4 | 74 | -16.4% |
| West Virginia | $192 | $802 | 13 | 289 | -16.5% |
| Missouri | $190 | $928 | 49 | 1,099 | -17.1% |
| New Mexico | $188 | $937 | 7 | 104 | -18.0% |
| Iowa | $186 | $1,354 | 12 | 96 | -19.0% |
| South Dakota | $183 | $305 | 2 | 12 | -20.4% |
| Nebraska | $183 | $732 | 11 | 284 | -20.4% |
| Wisconsin | $182 | $2,275 | 33 | 320 | -20.6% |
| Arkansas | $168 | $977 | 7 | 78 | -27.0% |
⚠️ 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