CPT 43237 · professional fee

Endoscopic us exam esoph (CPT 43237): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 43237, from their published in-network rate files.

GastroenterologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$318

P10 to P90: $204 to $594

vs Medicare

184%

non-facility rate $173.02

Payer spread

1.46×

UHC $365 vs Aetna $251

State spread

3.3×

AK $779 to MD $235

4,421 sampled providers5,124 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 43237 in the files analyzed, at $365, 46% above Aetna ($251), the lowest of the 4 payers shown.

The state spread is 3.3×: Alaska has the highest median at $779 and Maryland the lowest at $235, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 184% of the Medicare non-facility rate ($173.02), which ranks 59th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Cigna (interquartile range $159) and widest within Aetna ($149).

This is a top-35 code for gastroenterology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$365	$282	$475	+15%	1	3,759	211% of Medicare
Cigna	$330	$268	$426	+4%	2	3,593	190% of Medicare
Blue Cross Blue Shield	$313	$238	$412	-2%	3	3,549	181% of Medicare
Aetna	$251	$206	$355	-21%	4	2,519	145% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($173.02)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$779	+145%	n/a	n/a	16
2	Wisconsin	$677	+113%	UHC	Aetna	106
3	Oregon	$599	+88%	UHC	Aetna	104
4	New Hampshire	$460	+45%	UHC	Aetna	74
5	Nebraska	$435	+37%	UHC	BCBS	46
6	Minnesota	$435	+37%	UHC	Aetna	91
7	Washington	$425	+34%	UHC	BCBS	96
8	Georgia	$423	+33%	BCBS	UHC	125
9	Iowa	$421	+32%	Cigna	Aetna	55
10	Connecticut	$419	+32%	UHC	Aetna	122
11	Massachusetts	$395	+24%	UHC	Aetna	113
12	South Dakota	$394	+24%	BCBS	UHC	25
13	North Carolina	$383	+20%	BCBS	Aetna	124
14	Idaho	$382	+20%	Aetna	Cigna	52
15	Mississippi	$380	+19%	Aetna	Cigna	92
16	North Dakota	$372	+17%	BCBS	UHC	20
17	Tennessee	$341	+7%	UHC	Aetna	109
18	New Mexico	$336	+6%	UHC	BCBS	58
19	New Jersey	$334	+5%	Cigna	Aetna	116
20	Vermont	$333	+5%	UHC	BCBS	23
21	Utah	$333	+5%	Aetna	BCBS	88
22	Missouri	$332	+4%	UHC	Aetna	135
23	Kansas	$323	+2%	Cigna	Aetna	62
24	Ohio	$321	+1%	UHC	BCBS	123
25	Kentucky	$318	-0%	UHC	Aetna	124
26	Arizona	$318	-0%	UHC	BCBS	98
27	Arkansas	$315	-1%	UHC	Aetna	81
28	Colorado	$313	-2%	UHC	BCBS	122
29	Louisiana	$313	-2%	UHC	Aetna	120
30	Illinois	$307	-4%	UHC	BCBS	115
31	Montana	$303	-5%	UHC	Cigna	28
32	Rhode Island	$303	-5%	UHC	BCBS	66
33	South Carolina	$299	-6%	BCBS	Aetna	112
34	District of Columbia	$298	-6%	Cigna	BCBS	51
35	Maine	$293	-8%	UHC	Aetna	53
36	West Virginia	$291	-9%	UHC	Aetna	49
37	Pennsylvania	$281	-12%	UHC	Aetna	114
38	Virginia	$281	-12%	UHC	BCBS	117
39	California	$277	-13%	Cigna	Aetna	108
40	Indiana	$275	-14%	UHC	Aetna	110
41	Alabama	$272	-15%	Aetna	Cigna	114
41	Florida	$272	-15%	UHC	Aetna	117
43	New York	$270	-15%	UHC	BCBS	131
44	Michigan	$267	-16%	UHC	Aetna	111
45	Oklahoma	$258	-19%	UHC	Aetna	98
46	Delaware	$246	-23%	UHC	Aetna	29
47	Texas	$243	-24%	Cigna	BCBS	132
48	Nevada	$243	-24%	UHC	Aetna	84
49	Hawaii	$238	-25%	UHC	Cigna	45
50	Maryland	$235	-26%	UHC	BCBS	109

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 43237?

In the files we analyzed, UnitedHealthcare, at a median of $365 across 3,759 sampled providers. Aetna is lowest at $251, 46% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 184% of the 2026 Medicare non-facility rate of $173.02.

Which state has the highest median for CPT 43237?

Alaska has the highest median at $779; Maryland has the lowest at $235.

Is this the surgeon, physician or facility payment?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

See how your contracts compare for CPT 43237

Benchmark your negotiated rates for 43237 and the rest of your book against these payer and state medians.

Request a rate benchmark