Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare
Medicare pricing data for 11,476 providers across 52 states
Prices vary significantly by location — from $160 in North Dakota to $431 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
Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare (HCPCS code 43251) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $319.58, but hospitals typically charge $1,531 — a 4.8x 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 $319.58, your out-of-pocket cost would be approximately $63.92. 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 4.8x more than what Medicare allows for this procedure. Medicare actually pays $253.69 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Wyoming | $431 | $2,061 | 22 | 116 | +34.7% |
| Alaska | $428 | $2,327 | 28 | 80 | +34.0% |
| Nevada | $405 | $1,564 | 61 | 311 | +26.9% |
| New York | $402 | $2,407 | 746 | 3,805 | +25.7% |
| Maryland | $389 | $1,553 | 240 | 1,770 | +21.6% |
| California | $389 | $2,021 | 988 | 6,104 | +21.6% |
| Hawaii | $384 | $1,677 | 33 | 196 | +20.3% |
| Puerto Rico | $374 | $407 | 28 | 68 | +17.0% |
| Rhode Island | $368 | $1,370 | 43 | 272 | +15.0% |
| Arizona | $363 | $1,095 | 189 | 1,367 | +13.7% |
| Colorado | $356 | $1,752 | 169 | 1,023 | +11.5% |
| New Jersey | $353 | $2,060 | 408 | 2,056 | +10.5% |
| South Dakota | $351 | $1,153 | 35 | 262 | +9.7% |
| Delaware | $344 | $1,063 | 44 | 296 | +7.7% |
| Florida | $342 | $1,457 | 861 | 5,163 | +7.1% |
| North Carolina | $335 | $1,099 | 411 | 2,151 | +4.9% |
| Mississippi | $330 | $1,440 | 96 | 712 | +3.4% |
| Iowa | $329 | $1,233 | 90 | 948 | +3.1% |
| Georgia | $328 | $1,408 | 322 | 1,131 | +2.8% |
| Arkansas | $318 | $947 | 98 | 595 | -0.6% |
| Idaho | $311 | $1,145 | 59 | 346 | -2.6% |
| Texas | $309 | $1,891 | 851 | 4,474 | -3.2% |
| Oregon | $307 | $1,562 | 136 | 357 | -3.9% |
| Connecticut | $305 | $1,273 | 163 | 647 | -4.5% |
| Louisiana | $304 | $1,000 | 153 | 685 | -4.9% |
| Kansas | $303 | $1,292 | 103 | 683 | -5.3% |
| Washington | $299 | $1,055 | 263 | 1,218 | -6.3% |
| Pennsylvania | $297 | $1,017 | 604 | 2,655 | -7.2% |
| Illinois | $295 | $1,578 | 492 | 2,810 | -7.7% |
| Nebraska | $280 | $1,417 | 72 | 951 | -12.4% |
| Alabama | $280 | $1,341 | 152 | 640 | -12.5% |
| Oklahoma | $275 | $1,008 | 114 | 775 | -14.0% |
| Ohio | $273 | $1,132 | 499 | 1,895 | -14.5% |
| New Mexico | $268 | $1,085 | 50 | 160 | -16.1% |
| South Carolina | $268 | $1,102 | 196 | 1,155 | -16.1% |
| Tennessee | $263 | $1,260 | 229 | 817 | -17.7% |
| Massachusetts | $262 | $1,041 | 344 | 1,300 | -18.0% |
| Indiana | $260 | $1,493 | 229 | 1,114 | -18.7% |
| Michigan | $255 | $835 | 321 | 1,273 | -20.1% |
| Utah | $249 | $1,340 | 66 | 299 | -22.0% |
| Minnesota | $249 | $1,425 | 207 | 554 | -22.0% |
| Virginia | $249 | $1,559 | 294 | 1,372 | -22.1% |
| New Hampshire | $247 | $2,038 | 66 | 443 | -22.8% |
| Kentucky | $240 | $1,101 | 181 | 613 | -24.9% |
| Missouri | $231 | $1,216 | 243 | 1,102 | -27.7% |
| Wisconsin | $218 | $2,693 | 226 | 761 | -31.8% |
| Montana | $189 | $993 | 28 | 145 | -40.8% |
| Maine | $182 | $761 | 51 | 175 | -42.9% |
| Vermont | $181 | $1,325 | 20 | 81 | -43.4% |
| District of Columbia | $173 | $822 | 35 | 72 | -45.9% |
| West Virginia | $168 | $845 | 51 | 143 | -47.4% |
| North Dakota | $160 | $1,359 | 28 | 176 | -50.0% |
⚠️ 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