District of Columbia

Cost of a EGD with Biopsy Visit
in District of Columbia

Name: Upper Endoscopy with Biopsy Cost in District of Columbia (2026)
Creator: Jayant Panwar
Published: 2026-03-18

Reviewed by Momentary Medical Group West PC

District of Columbia's healthcare market operates in a unique federal jurisdiction where costs run approximately 20% above national averages due to high operational expenses and concentrated provider networks. Patients seeking an EGD with Biopsy in DC typically encounter negotiated rates ranging from $86 to $995, with a median cost of $432 based on transparency data from 346 active providers. The district's concentrated healthcare landscape offers numerous specialized gastroenterology practices, allowing patients to browse multiple options when comparing costs and scheduling their upper endoscopy procedures.

Average

$504

Median

$432

Lowest

$86

Highest

$995

Providers

346

National avg: $538District of Columbia: $504

6% below national average

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Just $19.99/mo

Compare Similar Procedures

How does upper endoscopy with biopsy compare to related procedures in District of Columbia?

Procedure	CPT	Low	Median	High	Providers
Colonoscopy Diagnostic colonoscopy	45378	$126	$368	$815	326
Colonoscopy with Biopsy Colonoscopy with biopsy	45380	$98	$498	$1,143	342
Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare	45385	$212	$593	$1,372	333
Upper Endoscopy (EGD) Diagnostic upper GI endoscopy	43235	$115	$344	$701	315
ECG / EKG 12-lead electrocardiogram with interpretation	93000	$13	$31	$85	380
Echocardiogram Transthoracic echocardiogram with Doppler	93306	$59	$192	$569	354
OB Ultrasound Obstetric ultrasound, complete	76805	$39	$117	$342	342

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.

Full data methodology and glossary

Why EGD with Biopsy Visit Costs Vary Across District of Columbia

District of Columbia's healthcare costs run approximately 20% above national averages, driven by the unique federal jurisdiction's high operational expenses, premium real estate costs, and concentration of specialized medical facilities. The district's compact geography creates intense competition for prime medical office locations, while the affluent patient population supports premium pricing structures.

Urban vs. Rural Provider Availability

As a entirely urban jurisdiction, District of Columbia concentrates all healthcare services within a small metropolitan area, eliminating rural access issues but creating premium pricing due to high real estate and operational costs. Patients benefit from numerous gastroenterology options within a compact area, though this concentration also supports higher average fees. The district's proximity to suburban Maryland and Virginia provides additional options for cost-conscious patients willing to travel.

Facility Type and Overhead Costs

Major health systems like MedStar Washington Hospital Center and George Washington University Hospital operate large gastroenterology departments with higher overhead costs reflected in EGD with Biopsy pricing. Independent gastroenterology practices in District of Columbia often offer more competitive rates due to lower facility fees, though they may have less availability for complex cases. Hospital-based procedures typically include separate facility charges that can significantly increase total costs.

Insurance Market Competition in District of Columbia

CareFirst BCBS dominates the District of Columbia market with significant enrollment, while UHC and Aetna provide competitive alternatives that negotiate different rates with gastroenterology providers. The concentrated market with relatively few major insurers can limit competitive pressure on negotiated rates, potentially keeping EGD with Biopsy costs elevated. Federal employee health benefits plans also influence the market dynamics, as many district residents access care through FEHB options.

Physician Supply and Demand in District of Columbia

With 346 active providers offering EGD with Biopsy services, District of Columbia maintains a robust supply of gastroenterologists relative to its compact population, though high demand from the metropolitan area keeps utilization high. This adequate provider supply helps moderate wait times for non-urgent procedures, though the affluent patient population and medical tourism from surrounding areas support premium pricing. The concentration of academic medical centers attracts specialists, maintaining good access to advanced endoscopic procedures.

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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.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — EGD with Biopsy Costs in District of Columbia

What is the average cost of a EGD with Biopsy visit in District of Columbia without insurance?

Without insurance, EGD with Biopsy procedures in District of Columbia typically cost between $86 and $995, with a median price of $432 based on negotiated rates from 346 providers. Actual self-pay costs may be higher since these figures represent insurance negotiated rates, though many practices offer cash-pay discounts. The total cost depends on facility type, with hospital-based procedures generally more expensive than independent gastroenterology practices.

Does District of Columbia Medicaid cover EGD with Biopsy visits?

Yes, District of Columbia expanded Medicaid covers EGD with Biopsy visits when medically necessary, as the district implemented Medicaid expansion under the Affordable Care Act. Coverage includes both the procedure and related physician services when performed by participating gastroenterologists. Prior authorization may be required for certain indications, so working with providers experienced in Medicaid requirements helps avoid coverage delays.

How do I find an affordable EGD with Biopsy near me in District of Columbia?

Compare costs between independent gastroenterology practices and hospital-based facilities, as independent practices often have lower overhead costs and facility fees. Ask about self-pay discounts if you're uninsured, as many District of Columbia providers offer 10-30% cash-pay reductions. Community health centers in the district may also provide gastroenterology services on sliding scale fee schedules based on income.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial EGD with Biopsy consultations typically cost more than follow-up visits due to the comprehensive evaluation required for new patients, including detailed history taking and treatment planning. Follow-up visits for established patients focus on specific issues and procedure results, requiring less time and documentation. The median negotiated rate of $432 generally applies to the procedure itself, with separate consultation fees depending on visit complexity.

Can I use an HSA or FSA to pay for a EGD with Biopsy visit in District of Columbia?

Yes, EGD with Biopsy visits qualify as eligible medical expenses for both HSA and FSA accounts, including consultation fees, procedure costs, and related diagnostic services. You can use these tax-advantaged funds to pay for deductibles, copays, and coinsurance associated with the visit. Keep receipts for all related expenses, as the IRS may require documentation for qualified medical expense claims.

How does telemedicine affect the cost of seeing a EGD with Biopsy in District of Columbia?

While the EGD procedure itself requires in-person visits, initial consultations and follow-up appointments may be available via telemedicine at reduced costs compared to office visits. District of Columbia has expanded telehealth coverage since 2020, with many insurers covering virtual gastroenterology consultations at the same rate as office visits. Telemedicine can help reduce overall costs by minimizing travel and time off work, though the actual endoscopy procedure must be performed in a medical facility.

Click a state to compare costs

Average Visit Cost

$228

$2,029

Office visit (CPT 43239)

Compare With Other States

Rank	State	Average↓	Min⇅	Max⇅	Providers⇅
1	Wisconsin(WI) Range: $116 – $5,357	$2,029	$116	$5,357	2,133
2	North Dakota(ND) Range: $181 – $2,396	$1,658	$181	$2,396	470
3	Minnesota(MN) Range: $90 – $2,396	$1,627	$90	$2,396	1,809
4	South Dakota(SD) Range: $85 – $2,396	$938	$85	$2,396	77
5	Massachusetts(MA) Range: $80 – $1,654	$747	$80	$1,654	1,412
6	New York(NY) Range: $166 – $1,647	$743	$166	$1,647	31,089
7	New Hampshire(NH) Range: $341 – $1,085	$715	$341	$1,085	3,694
8	Rhode Island(RI) Range: $80 – $1,647	$715	$80	$1,647	83
9	Connecticut(CT) Range: $85 – $1,647	$711	$85	$1,647	461
10	Delaware(DE) Range: $80 – $1,647	$684	$80	$1,647	98
11	West Virginia(WV) Range: $80 – $1,647	$675	$80	$1,647	122
12	Pennsylvania(PA) Range: $80 – $1,647	$666	$80	$1,647	1,592
13	Maine(ME) Range: $404 – $783	$631	$404	$783	1,551
14	Nebraska(NE) Range: $195 – $902	$629	$195	$902	2,207
15	Oregon(OR) Range: $80 – $1,352	$553	$80	$1,352	416
16	Vermont(VT) Range: $273 – $907	$552	$273	$907	339
17	Wyoming(WY) Range: $173 – $1,151	$549	$173	$1,151	184
18	California(CA) Range: $80 – $1,352	$542	$80	$1,352	16,316
19	Georgia(GA) Range: $85 – $1,084	$522	$85	$1,084	3,187
20	Iowa(IA) Range: $85 – $902	$516	$85	$902	293
21	New Jersey(NJ) Range: $83 – $1,165	$508	$83	$1,165	6,615
22	District of Columbia(DC) Range: $86 – $995	$504	$86	$995	346
23	North Carolina(NC) Range: $80 – $1,088	$495	$80	$1,088	2,729
24	Missouri(MO) Range: $130 – $712	$436	$130	$712	5,404
25	Utah(UT) Range: $80 – $820	$428	$80	$820	441
26	New Mexico(NM) Range: $90 – $834	$424	$90	$834	1,281
27	Washington(WA) Range: $80 – $954	$423	$80	$954	5,547
28	Hawaii(HI) Range: $80 – $903	$411	$80	$903	92
29	Maryland(MD) Range: $121 – $810	$401	$121	$810	4,050
30	Indiana(IN) Range: $80 – $810	$399	$80	$810	411
31	Colorado(CO) Range: $85 – $829	$383	$85	$829	1,652
32	Kentucky(KY) Range: $60 – $830	$370	$60	$830	282
33	Illinois(IL) Range: $70 – $696	$368	$70	$696	5,884
34	Arkansas(AR) Range: $85 – $712	$361	$85	$712	140
35	Virginia(VA) Range: $90 – $728	$358	$90	$728	2,890
36	Idaho(ID) Range: $80 – $802	$356	$80	$802	191
37	Michigan(MI) Range: $80 – $685	$341	$80	$685	2,142
38	Mississippi(MS) Range: $114 – $621	$340	$114	$621	1,314
39	Kansas(KS) Range: $130 – $526	$333	$130	$526	1,766
40	Louisiana(LA) Range: $85 – $634	$331	$85	$634	954
41	Texas(TX) Range: $80 – $649	$320	$80	$649	12,607
42	Ohio(OH) Range: $85 – $621	$309	$85	$621	4,786
43	South Carolina(SC) Range: $80 – $627	$306	$80	$627	1,357
44	Alabama(AL) Range: $80 – $566	$305	$80	$566	2,667
45	Nevada(NV) Range: $85 – $571	$304	$85	$571	2,691
46	Tennessee(TN) Range: $85 – $604	$296	$85	$604	2,698
47	Oklahoma(OK) Range: $85 – $569	$264	$85	$569	1,728
48	Alaska(AK) Range: $80 – $606	$255	$80	$606	373
49	Florida(FL) Range: $35 – $659	$250	$35	$659	5,570
50	Arizona(AZ) Range: $81 – $493	$245	$81	$493	6,206
51	Montana(MT) Range: $80 – $523	$228	$80	$523	327

Cost of a EGD with Biopsy Visitin District of Columbia