What is the standard insurance baseline for CPT 45342?

The standard insurance baseline reimbursement rate is $184.24. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Fine Needle Aspiration and or Biopsy of Lower Large Bowel with Ultrasound Guidance using a Flexible Endoscope

CPT 45342Medical Service

Fine Needle Aspiration and or Biopsy of Lower Large Bowel with Ultrasound Guidance using a Flexible Endoscope

Q: What do doctors typically charge for Fine Needle Aspiration and or Biopsy of Lower Large Bowel with Ultrasound Guidance using a Flexible Endoscope?

The nationwide median physician charge for Fine Needle Aspiration and or Biopsy of Lower Large Bowel with Ultrasound Guidance using a Flexible Endoscope (CPT 45342) is $987.16. Doctor billed charges vary based on geographic region, setting, and overhead.

Fine needle aspiration and/or biopsy of lower large bowel with ultrasound guidance using a flexible endoscope. Clinical pricing breakdown and utilization metrics across 2 practicing doctors nationwide.

$987.16

Peer Median Charge

Gross billed rate

$184.24

Standard Baseline

Customary allowable

5.4x

National Markup

Charge vs baseline

Active Physicians

Billing this code

Planning care or already received a bill for CPT 45342?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Calculate Bundled Cost →Dispute an Inflated Bill 🧾

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $987.16. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $184.24 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 45342 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"