Cost of a EGD with Biopsy Visit
in Colorado
Reviewed by Momentary Medical Group West PC
Colorado's competitive ambulatory surgery center market, particularly concentrated around Denver, has created significant price variation for EGD with Biopsy procedures across the state. Patients typically pay between $85 and $829, with a median cost of $236 based on negotiated insurance rates from over 1,650 active providers. Colorado maintains a robust network of gastroenterology specialists and endoscopy centers, allowing patients to browse providers statewide and compare costs before scheduling their procedure.
Average
$383
Median
$236
Lowest
$85
Highest
$829
Providers
1,652
29% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Colorado?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $309 | $760 | 1,571 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $344 | $969 | 1,596 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $85 | $467 | $1,282 | 1,413 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $117 | $243 | $627 | 1,345 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $16 | $26 | $85 | 1,878 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $77 | $169 | $428 | 1,528 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $51 | $104 | $275 | 1,580 |
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.
Why EGD with Biopsy Visit Costs Vary Across Colorado
Colorado's healthcare costs run approximately 7% above the national average, influenced by the state's growing population and concentration of medical facilities along the Front Range corridor. The competitive ambulatory surgery center market in Denver creates pricing pressure that benefits patients seeking EGD with Biopsy procedures.
Urban vs. Rural Provider Availability
The Denver-Boulder metropolitan area contains most of Colorado's gastroenterology specialists, while rural areas like the Western Slope and Eastern Plains have limited options. Patients in rural counties may need to travel to Colorado Springs, Denver, or Grand Junction for specialized endoscopy services. This geographic concentration can drive up costs in urban areas but may require additional travel expenses for rural patients.
Facility Type and Overhead Costs
Hospital-owned outpatient endoscopy centers typically charge higher facility fees than independent ambulatory surgery centers in Colorado. Major health systems like Presbyterian/St. Joseph, UCHealth, and SCL Health operate numerous locations with varying cost structures. Independent endoscopy centers often offer more competitive pricing due to lower administrative overhead.
Insurance Market Competition in Colorado
Colorado benefits from robust competition between UnitedHealth, Anthem, and Kaiser Permanente, which helps moderate negotiated rates for EGD with Biopsy procedures. The state's insurance exchange offers additional plan options that can influence procedure costs. This competitive environment generally results in better negotiated rates compared to states with dominant single insurers.
Physician Supply and Demand in Colorado
With over 1,650 providers offering EGD with Biopsy procedures, Colorado maintains adequate specialist availability in urban areas. This robust supply helps contain costs through competition, though demand continues growing with the state's expanding population. Wait times are generally reasonable in metro areas, while rural regions may experience longer scheduling delays.
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 Colorado
What is the average cost of a EGD with Biopsy visit in Colorado without insurance?
Does Colorado Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Colorado?
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 Colorado?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Colorado?
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 |