Cost of a EGD with Biopsy Visit
in Indiana
Reviewed by Momentary Medical Group West PC
Indiana's healthcare costs run approximately 6% below the national average, offering patients more affordable access to specialized care across the state's mix of urban medical centers and rural facilities. For an EGD with Biopsy procedure, Indiana patients typically pay between $80 and $810, with a median cost of $308 based on negotiated insurance rates. With 411 active providers performing EGD with Biopsy procedures throughout Indiana, patients have substantial options when selecting care. Browse all qualified providers in Indiana to compare costs and find the right specialist for your needs.
Average
$399
Median
$308
Lowest
$80
Highest
$810
Providers
411
26% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Indiana?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $81 | $359 | $835 | 374 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $365 | $937 | 390 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $512 | $1,197 | 351 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $90 | $304 | $691 | 296 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $28 | $88 | 781 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $65 | $170 | $436 | 417 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $45 | $101 | $280 | 381 |
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 Indiana
Healthcare costs in Indiana run about 6% below national averages, reflecting the state's lower cost of living and competitive insurance market with multiple major players. The state's growing ambulatory surgery center market has helped contain costs for outpatient procedures like EGD with Biopsy by providing alternatives to more expensive hospital-based care.
Urban vs. Rural Provider Availability
Indiana's gastroenterology specialists concentrate heavily in metropolitan areas like Indianapolis, Fort Wayne, and Evansville, while rural counties often have limited or no local access. Patients in rural areas frequently travel 50+ miles for specialized care, with some choosing lower-cost rural hospitals over urban academic centers. This geographic disparity affects both access and pricing across different regions of the state.
Facility Type and Overhead Costs
Indiana has seen significant growth in independent ambulatory surgery centers, which typically offer EGD with Biopsy procedures at 30-50% less cost than hospital outpatient departments. Major health systems like Indiana University Health and Parkview Health operate hospital-based facilities with higher overhead costs reflected in their pricing. The state's competitive ASC market helps keep procedure costs more affordable for patients.
Insurance Market Competition in Indiana
Anthem Blue Cross Blue Shield, UnitedHealthcare, and MDwise dominate Indiana's insurance market, creating competitive negotiated rates for specialized procedures. The presence of multiple major insurers prevents any single company from dictating terms, generally benefiting patients through better coverage and competitive pricing. Rural areas may have fewer insurer options, potentially leading to higher costs in those markets.
Physician Supply and Demand in Indiana
With 411 active providers performing EGD with Biopsy procedures, Indiana maintains adequate specialist availability relative to its population of 6.8 million residents. This healthy supply-demand balance helps keep procedure costs reasonable compared to states with physician shortages. Wait times for routine procedures are generally manageable, though urgent cases may still face scheduling challenges during peak periods.
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 Indiana
What is the average cost of a EGD with Biopsy visit in Indiana without insurance?
Does Indiana Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Indiana?
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 Indiana?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Indiana?
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 |