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  4. /CPT 91040
CPT 91040

PR ESOPHGL BALO DISTENSION DX STD W/PROVOCATION at Northwest Iowa Hospital Corporation

Sioux City, IA

Pricing by billing methodology

Price type

All methodologies

$470

Aggregated across all available billing methodologies for this code.

Case rate

$535

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$461

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$316

Reflects a negotiated percentage of total billed charges.

Other

—

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Jan 28, 2026

Compare to other hospitals

See PR ESOPHGL BALO DISTENSION DX STD W/PROVOCATION pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.

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