ERCP procedure with sphincterotomy at MVHS, Inc.

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ercp W/Sphincterotomy/Papillotomy

Utica, NY

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Pricing by billing methodology

Price type

How this price compares nationally

MVHS, Inc.’s median price of $227 is 94% below the median hospital's median price ($3.9k), higher than 1% of the 2,001 hospitals reporting CPT 43262. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 43262 at MVHS, Inc.

Negotiated rates from the hospital’s own file: 12 payers, 34 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Excellus excellus bcbs medicaid hmo fee schedule · outpatient	$8	$8	—	—	—	$8 – $8
2	UnitedHealthcare uhc medicare advantage percent of total billed charges · inpatientfrom % of charges	$83	$83	—	—	—	$83 – $83
3	Humana humana military percent of total billed charges · inpatientfrom % of charges	$142	$142	—	—	—	$142 – $142
4	Tricare humana military percent of total billed charges · inpatientfrom % of charges	$142	$142	—	—	—	$142 – $142
5	Aetna aetna medicare advantage fee schedule · both	$150	$150	—	—	—	$150 – $150
6	Medicare medicare fee schedule · both	$150	$150	—	—	—	$150 – $150
7	WellCare wellcare fee schedule · both	$155	$155	—	—	—	$155 – $155
8	Humana choicecare fee schedule · both	$164	$164	—	—	—	$164 – $164
9	Humana humana medicare advantage fee schedule · both	$164	$164	—	—	—	$164 – $164
10	Medical Mutual worker's compensation and no fault fee schedule · outpatient	$227	$227	—	—	—	$227 – $227
11	Cigna mvp hmo/ppo fee schedule · both	$232	$232	—	—	—	$232 – $232
12	Blue Cross Blue Shield excellus bcbs federal fee schedule · both	$237	$237	—	—	—	$237 – $237
13	UnitedHealthcare uhc empire plan fee schedule · outpatient	$467	$467	$285	61%	—	$183 – $752
14	UnitedHealthcare uhc commercial case rate · inpatient	$2.6k	$2.6k	—	—	—	$2.6k – $2.6k
15	Humana humana military other · outpatient	$4.3k	$4.3k	—	—	—	$4.3k – $4.3k
16	Tricare humana military other · outpatient	$4.3k	$4.3k	—	—	—	$4.3k – $4.3k
17	UnitedHealthcare uhc empire plan percent of total billed charges · inpatientfrom % of charges	$4.6k	$4.6k	—	—	—	$4.6k – $4.6k
18	Excellus excellus bcbs medicare advantage other · outpatient	$4.8k	$4.8k	—	—	1–10	$4.8k – $4.8k
19	Humana humana medicare advantage other · outpatient	$4.8k	$4.8k	—	—	1–10	$4.8k – $4.8k
20	Medicare medicare other · outpatient	$4.8k	$4.8k	—	—	1–10	$4.8k – $4.8k
21	Optum vaccn optum other · outpatient	$4.8k	$4.8k	—	—	—	$4.8k – $4.8k
22	UnitedHealthcare uhc medicare advantage other · outpatient	$4.9k	$4.9k	—	—	—	$4.9k – $4.9k
23	Aetna aetna medicare advantage other · outpatient	$4.9k	$4.9k	—	—	—	$4.9k – $4.9k
24	WellCare wellcare medicare advantage other · outpatient	$5.0k	$5.0k	—	—	1–10	$5.0k – $5.0k
25	UnitedHealthcare uhc commercial fee schedule · outpatient	$6.2k	$6.2k	—	—	—	$6.2k – $6.2k

Page 1 of 2 · 34 rates

Last updated: Aug 7, 2026

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