Cost of a EGD with Biopsy Visit
in Idaho
Reviewed by Momentary Medical Group West PC
Idaho's rural healthcare landscape spans vast geographic distances, with many residents traveling significant miles to reach specialized gastroenterology services. Patients seeking an EGD with Biopsy in Idaho typically pay between $80 and $802, with a median out-of-pocket cost of $188 based on negotiated insurance rates. The state has 191 active providers offering these services across major metropolitan areas and smaller communities.
Average
$356
Median
$188
Lowest
$80
Highest
$802
Providers
191
34% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Idaho?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $80 | $273 | $735 | 165 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $272 | $906 | 186 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $400 | $3,638 | 163 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $86 | $239 | $623 | 95 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $26 | $90 | 383 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $78 | $131 | $430 | 189 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $85 | $591 | 200 |
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 Idaho
Idaho's healthcare costs run approximately 3% below national averages, reflecting the state's lower overall cost of living and rural market dynamics. However, geographic isolation and limited specialist density in many regions can create access challenges that influence pricing patterns.
Urban vs. Rural Provider Availability
The Boise metropolitan area concentrates most of Idaho's gastroenterology specialists, while rural counties often have limited or no local endoscopy services. This geographic disparity forces many patients to travel long distances, potentially adding indirect costs while also creating higher demand for urban providers.
Facility Type and Overhead Costs
Hospital-owned specialty clinics in Idaho often charge facility fees in addition to physician fees, increasing total procedure costs compared to independent ambulatory surgery centers. Major health systems like Saint Alphonsus and Kootenai Health have significant market presence, influencing regional pricing structures through their network effects.
Insurance Market Competition in Idaho
Idaho's insurance market shows moderate competition with Regence BlueCross and PacificSource holding substantial market share alongside smaller regional insurers. Limited insurer competition in rural markets can result in higher negotiated rates, while urban areas typically see more competitive pricing due to greater plan options.
Physician Supply and Demand in Idaho
With 191 active providers offering EGD with biopsy services statewide, Idaho maintains reasonable specialist availability relative to its population size. This supply level suggests adequate competition among providers in major metropolitan areas, though rural regions may experience longer wait times and higher costs due to limited local options.
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 Idaho
What is the average cost of a EGD with Biopsy visit in Idaho without insurance?
Does Idaho Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Idaho?
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 Idaho?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Idaho?
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 |