Insertion of stent into pancreatic or bile duct using a flexible endoscope
Medicare pricing data for 3,987 providers across 51 states
Prices vary significantly by location — from $347 in South Dakota to $885 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
Insertion of stent into pancreatic or bile duct using a flexible endoscope (HCPCS code 43274) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $410.65, but hospitals typically charge $1,761 — a 4.3x 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 $410.65, your out-of-pocket cost would be approximately $82.13. 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 4.3x more than what Medicare allows for this procedure. Medicare actually pays $326.22 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $885 | $4,879 | 9 | 74 | +115.6% |
| Rhode Island | $457 | $1,529 | 17 | 77 | +11.2% |
| Maryland | $452 | $1,352 | 61 | 770 | +10.1% |
| New York | $450 | $2,229 | 215 | 2,165 | +9.6% |
| Nevada | $448 | $1,345 | 27 | 217 | +9.1% |
| District of Columbia | $447 | $1,647 | 13 | 273 | +8.9% |
| Delaware | $445 | $1,056 | 9 | 163 | +8.4% |
| New Jersey | $444 | $2,514 | 128 | 1,060 | +8.2% |
| Florida | $434 | $1,436 | 302 | 2,140 | +5.6% |
| Illinois | $432 | $1,933 | 154 | 1,714 | +5.3% |
| California | $431 | $1,724 | 400 | 3,574 | +4.9% |
| Vermont | $430 | $2,515 | 6 | 33 | +4.8% |
| Connecticut | $428 | $2,157 | 49 | 382 | +4.2% |
| Wyoming | $424 | $3,204 | 7 | 31 | +3.3% |
| New Mexico | $422 | $1,297 | 12 | 105 | +2.8% |
| Utah | $421 | $1,230 | 25 | 200 | +2.6% |
| Massachusetts | $417 | $1,950 | 91 | 1,349 | +1.6% |
| Wisconsin | $417 | $3,527 | 91 | 704 | +1.6% |
| Texas | $415 | $1,838 | 344 | 2,623 | +1.2% |
| New Hampshire | $414 | $6,648 | 24 | 241 | +0.8% |
| Louisiana | $412 | $1,465 | 66 | 471 | +0.4% |
| Pennsylvania | $408 | $1,774 | 208 | 1,952 | -0.7% |
| Washington | $407 | $1,415 | 78 | 1,191 | -0.9% |
| South Carolina | $406 | $1,792 | 69 | 818 | -1.2% |
| Kansas | $405 | $1,258 | 26 | 326 | -1.3% |
| Mississippi | $405 | $1,596 | 29 | 182 | -1.4% |
| Ohio | $404 | $1,664 | 132 | 1,291 | -1.5% |
| Tennessee | $403 | $1,651 | 96 | 759 | -1.9% |
| Montana | $402 | $1,293 | 17 | 132 | -2.0% |
| Georgia | $401 | $1,498 | 115 | 742 | -2.4% |
| Arkansas | $401 | $3,459 | 35 | 240 | -2.4% |
| Minnesota | $399 | $1,998 | 54 | 1,007 | -2.8% |
| Michigan | $398 | $1,271 | 143 | 1,187 | -3.0% |
| West Virginia | $396 | $1,461 | 23 | 353 | -3.6% |
| Hawaii | $393 | $1,086 | 13 | 67 | -4.2% |
| Colorado | $391 | $1,412 | 82 | 765 | -4.8% |
| Alabama | $390 | $1,535 | 47 | 393 | -5.0% |
| Idaho | $389 | $1,051 | 33 | 202 | -5.2% |
| North Carolina | $389 | $1,549 | 108 | 1,292 | -5.4% |
| Oklahoma | $388 | $1,723 | 33 | 392 | -5.6% |
| Oregon | $386 | $1,566 | 57 | 395 | -5.9% |
| Indiana | $385 | $1,699 | 90 | 984 | -6.2% |
| Virginia | $385 | $1,380 | 97 | 1,266 | -6.3% |
| Maine | $384 | $1,471 | 14 | 202 | -6.6% |
| North Dakota | $381 | $1,495 | 11 | 196 | -7.3% |
| Missouri | $376 | $1,490 | 97 | 1,780 | -8.4% |
| Arizona | $372 | $1,871 | 68 | 947 | -9.4% |
| Nebraska | $370 | $1,479 | 28 | 412 | -9.8% |
| Kentucky | $359 | $1,206 | 64 | 915 | -12.6% |
| Iowa | $357 | $1,658 | 30 | 298 | -13.1% |
| South Dakota | $347 | $1,437 | 8 | 207 | -15.4% |
⚠️ 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