Cost of a EGD with Biopsy Visit
in Delaware
Reviewed by Momentary Medical Group West PC
Delaware's position as the second smallest state creates unique healthcare dynamics, with most EGD with Biopsy services concentrated in the Wilmington-Dover corridor. Patients typically pay between $80 and $1,647 for an EGD with Biopsy visit, with a median out-of-pocket cost of $324 based on negotiated insurance rates. With 98 active providers statewide, Delaware offers reasonable access to upper endoscopy services, though costs can vary significantly depending on facility type and insurance network status.
Average
$684
Median
$324
Lowest
$80
Highest
$1,647
Providers
98
27% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Delaware?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $95 | $317 | $1,830 | 84 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $376 | $2,117 | 99 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $455 | $2,338 | 94 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $109 | $271 | $701 | 77 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $15 | $15 | $46 | 212 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $60 | $171 | $677 | 104 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $54 | $139 | $216 | 203 |
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 Delaware
Delaware's healthcare costs run approximately 11% above national averages, reflecting the state's position in the expensive Northeast corridor and limited healthcare market competition. The First State's small geographic footprint concentrates most specialist services in New Castle County, creating pricing dynamics influenced by proximity to higher-cost Philadelphia and Baltimore markets.
Urban vs. Rural Provider Availability
Most of Delaware's EGD with Biopsy providers cluster in the Wilmington metropolitan area and along the I-95 corridor, leaving residents of western Sussex County and rural Kent County with longer travel distances and fewer options. This geographic concentration allows urban providers to command premium pricing while creating access challenges for residents in agricultural areas like the Delmarva Peninsula. The state's compact size means most patients can reach specialist care within an hour, but rural residents often face higher indirect costs through travel and time off work.
Facility Type and Overhead Costs
ChristianaCare and Bayhealth dominate Delaware's hospital market, operating most hospital-based endoscopy centers that typically charge higher facility fees compared to independent ambulatory surgery centers. The state's limited real estate and high property costs in northern Delaware drive up overhead expenses for medical facilities, particularly those serving the Wilmington business corridor. Several independent gastroenterology practices have consolidated with larger health systems in recent years, reducing price competition and potentially increasing procedure costs.
Insurance Market Competition in Delaware
Delaware's small population supports a limited number of major insurers, with Highmark, Aetna, and UnitedHealthcare controlling most of the commercial market and reducing competitive pressure on negotiated rates. The state's proximity to major metropolitan areas creates cross-border insurance dynamics, as some Delaware residents maintain coverage tied to Philadelphia or Washington DC employers. This concentrated market structure can limit consumer choice and may contribute to higher negotiated rates between insurers and the state's dominant health systems.
Physician Supply and Demand in Delaware
With 98 active providers offering EGD with Biopsy services, Delaware maintains reasonable specialist availability relative to its population of under one million residents, though this represents dependence on a relatively small pool of practitioners. The state's position between major medical markets allows some physicians to maintain practices serving both Delaware and neighboring Pennsylvania or Maryland patients, potentially affecting scheduling availability and pricing strategies. Retirement of established gastroenterologists and challenges recruiting new specialists to a smaller market could impact future supply and pricing dynamics.
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 Delaware
What is the average cost of a EGD with Biopsy visit in Delaware without insurance?
Does Delaware Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Delaware?
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 Delaware?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Delaware?
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 |