Cost of a EGD with Biopsy Visit
in California
Reviewed by Momentary Medical Group West PC
California's healthcare market drives EGD with Biopsy costs approximately 18% above national averages, reflecting the state's high overhead expenses and concentrated metro markets. Patients typically pay between $80 and $1,352 for an EGD with Biopsy visit, with a median out-of-pocket cost of $196 based on negotiated insurance rates. California maintains over 16,000 active providers performing upper endoscopy with biopsy procedures, giving patients substantial options when browsing all providers throughout the state.
Average
$542
Median
$196
Lowest
$80
Highest
$1,352
Providers
16,316
1% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in California?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $85 | $647 | 5,883 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $308 | $1,785 | 12,256 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $30 | $453 | $1,785 | 9,290 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $80 | $85 | $598 | 6,177 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $16 | $49 | $88 | 22,603 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $79 | $101 | $586 | 17,572 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $52 | $90 | $287 | 7,619 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 43239 — EGD with biopsy). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 43239 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 43239 (EGD with biopsy), as mandated by the CMS Price Transparency Rule.
What CPT 43239 covers: the provider's professional fee for upper endoscopy with biopsy. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
EGD with Biopsy Visit Costs by City in California — 2026
EGD with Biopsy costs fluctuate significantly across California cities due to varying provider concentrations, facility types, and regional cost pressures from urban centers like San Francisco to rural inland areas. ---CITY_SUMMARIES--- Data not available for city-level cost breakdowns.
| City | Min Cost | Median Cost | Max Cost |
|---|---|---|---|
| Chula Vista | $80 | $912 | $912 |
| La Mesa | $85 | $912 | $912 |
| Del Mar | $419 | $912 | $912 |
| South Lake Tahoe | $326 | $427 | $526 |
| Manhattan Beach | $85 | $419 | $1,352 |
| Sherman Oaks | $85 | $412 | $1,352 |
| Los Angeles | $85 | $400 | $1,352 |
| West Hollywood | $106 | $400 | $415 |
| Beverly Hills | $85 | $400 | $1,352 |
| Encino | $85 | $400 | $1,352 |
Costs reflect self-pay estimates based on insurer-negotiated rates. Insured patients may pay significantly less depending on plan type, deductible status, and network tier.
Why EGD with Biopsy Visit Costs Vary Across California
California's healthcare costs run approximately 18% above national averages, driven by expensive real estate, high labor costs, and regulatory requirements that increase practice overhead expenses. The state's diverse geography creates dramatic cost variations between densely populated coastal metros and underserved inland regions where specialist access remains limited.
Urban vs. Rural Provider Availability
Los Angeles and San Francisco Bay Area markets offer abundant gastroenterology options with competitive pricing, while Central Valley and far Northern California counties often have single-provider markets. Rural patients frequently travel 100+ miles for EGD procedures, adding travel costs to already elevated procedure fees. Telemedicine consultations help bridge initial access gaps, though the actual endoscopy still requires in-person visits.
Facility Type and Overhead Costs
Hospital-owned gastroenterology practices in California charge facility fees that can double total procedure costs compared to independent physician-owned endoscopy centers. Major health systems like Sutter Health, Dignity Health, and Cedars-Sinai typically command premium pricing due to their market dominance and high overhead expenses. Ambulatory surgery centers offer cost-effective alternatives while maintaining quality standards.
Insurance Market Competition in California
California's insurance market features intense competition between Anthem Blue Cross, Kaiser Permanente, and UnitedHealthCare, leading to aggressive rate negotiations with providers. Kaiser's integrated model typically offers lower out-of-pocket costs but restricts patients to Kaiser gastroenterologists exclusively. Regional plans like Health Net and Blue Shield provide additional options with varying network adequacy across the state's 58 counties.
Physician Supply and Demand in California
California's 16,000+ providers performing EGD with Biopsy procedures indicate robust specialist availability in metro areas, though distribution favors coastal regions over inland counties. This supply concentration allows urban patients more cost comparison opportunities while rural residents face limited options and potentially higher fees. Wait times for non-urgent procedures typically range from 2-6 weeks in major cities versus 6-12 weeks in underserved areas.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — EGD with Biopsy Costs in California
What is the average cost of a EGD with Biopsy visit in California without insurance?
Does California Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in California?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a EGD with Biopsy visit in California?
How does telemedicine affect the cost of seeing a EGD with Biopsy in California?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 43239)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $116 – $5,357 | $2,029 |
| 2 | North Dakota Range: $181 – $2,396 | $1,658 |
| 3 | Minnesota Range: $90 – $2,396 | $1,627 |
| 4 | South Dakota Range: $85 – $2,396 | $938 |
| 5 | Massachusetts Range: $80 – $1,654 | $747 |
| 6 | New York Range: $166 – $1,647 | $743 |
| 7 | New Hampshire Range: $341 – $1,085 | $715 |
| 8 | Rhode Island Range: $80 – $1,647 | $715 |
| 9 | Connecticut Range: $85 – $1,647 | $711 |
| 10 | Delaware Range: $80 – $1,647 | $684 |
| 11 | West Virginia Range: $80 – $1,647 | $675 |
| 12 | Pennsylvania Range: $80 – $1,647 | $666 |
| 13 | Maine Range: $404 – $783 | $631 |
| 14 | Nebraska Range: $195 – $902 | $629 |
| 15 | Oregon Range: $80 – $1,352 | $553 |
| 16 | Vermont Range: $273 – $907 | $552 |
| 17 | Wyoming Range: $173 – $1,151 | $549 |
| 18 | California Range: $80 – $1,352 | $542 |
| 19 | Georgia Range: $85 – $1,084 | $522 |
| 20 | Iowa Range: $85 – $902 | $516 |
| 21 | New Jersey Range: $83 – $1,165 | $508 |
| 22 | District of Columbia Range: $86 – $995 | $504 |
| 23 | North Carolina Range: $80 – $1,088 | $495 |
| 24 | Missouri Range: $130 – $712 | $436 |
| 25 | Utah Range: $80 – $820 | $428 |
| 26 | New Mexico Range: $90 – $834 | $424 |
| 27 | Washington Range: $80 – $954 | $423 |
| 28 | Hawaii Range: $80 – $903 | $411 |
| 29 | Maryland Range: $121 – $810 | $401 |
| 30 | Indiana Range: $80 – $810 | $399 |
| 31 | Colorado Range: $85 – $829 | $383 |
| 32 | Kentucky Range: $60 – $830 | $370 |
| 33 | Illinois Range: $70 – $696 | $368 |
| 34 | Arkansas Range: $85 – $712 | $361 |
| 35 | Virginia Range: $90 – $728 | $358 |
| 36 | Idaho Range: $80 – $802 | $356 |
| 37 | Michigan Range: $80 – $685 | $341 |
| 38 | Mississippi Range: $114 – $621 | $340 |
| 39 | Kansas Range: $130 – $526 | $333 |
| 40 | Louisiana Range: $85 – $634 | $331 |
| 41 | Texas Range: $80 – $649 | $320 |
| 42 | Ohio Range: $85 – $621 | $309 |
| 43 | South Carolina Range: $80 – $627 | $306 |
| 44 | Alabama Range: $80 – $566 | $305 |
| 45 | Nevada Range: $85 – $571 | $304 |
| 46 | Tennessee Range: $85 – $604 | $296 |
| 47 | Oklahoma Range: $85 – $569 | $264 |
| 48 | Alaska Range: $80 – $606 | $255 |
| 49 | Florida Range: $35 – $659 | $250 |
| 50 | Arizona Range: $81 – $493 | $245 |
| 51 | Montana Range: $80 – $523 | $228 |