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Louisiana

Cost of a EGD with Biopsy Visit
in Louisiana

Reviewed by Momentary Medical Group West PC

Louisiana's healthcare system, anchored by major academic medical centers in New Orleans and Shreveport, serves patients across diverse urban and rural communities throughout the Bayou State. EGD with Biopsy patients typically pay between $85 and $634, with a median out-of-pocket cost of $274, depending on facility type and insurance coverage. With 954 active EGD with Biopsy providers across Louisiana's parishes, patients have multiple options for accessing care in both metropolitan areas and smaller communities.

Average

$331

Median

$274

Lowest

$85

Highest

$634

Providers

954

National avg: $538Louisiana: $331

39% below national average

Compare Similar Procedures

How does upper endoscopy with biopsy compare to related procedures in Louisiana?

ProcedureCPTLowMedianHighProviders
Colonoscopy

Diagnostic colonoscopy

45378$116$314$670946
Colonoscopy with Biopsy

Colonoscopy with biopsy

45380$85$376$804943
Colonoscopy with Polyp Removal

Colonoscopy with polyp removal by snare

45385$197$429$918894
Upper Endoscopy (EGD)

Diagnostic upper GI endoscopy

43235$96$229$484879
ECG / EKG

12-lead electrocardiogram with interpretation

93000$14$16$903,354
Echocardiogram

Transthoracic echocardiogram with Doppler

93306$57$148$342961
OB Ultrasound

Obstetric ultrasound, complete

76805$38$68$1591,206

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 43239EGD 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 Louisiana

Louisiana's healthcare costs run approximately 1% above the national average, influenced by the state's unique geography spanning from the Mississippi Delta to rural parishes and the concentration of medical resources in New Orleans, Baton Rouge, and Shreveport. The state's decision not to expand Medicaid creates additional cost pressures on both patients and providers across Louisiana's diverse communities.

Urban vs. Rural Provider Availability

Louisiana's EGD with Biopsy providers are heavily concentrated in the New Orleans metro area and along the I-10 corridor, with significantly fewer options in rural parishes across northern and western Louisiana. Patients in areas like the Florida Parishes or Acadiana region may need to travel considerable distances for specialized gastroenterology care. This geographic disparity often forces rural patients toward urban facilities with higher overhead costs.

Facility Type and Overhead Costs

Major health systems like Ochsner Health and LCMC Health operate numerous hospital-based outpatient clinics throughout Louisiana that typically charge facility fees on top of physician services. Independent gastroenterology practices, more common in mid-sized cities like Lake Charles and Monroe, often offer more transparent pricing without additional facility charges. Academic medical centers like LSU Health Sciences Center and Tulane carry research and teaching costs that influence their pricing structures.

Insurance Market Competition in Louisiana

Blue Cross Blue Shield of Louisiana holds significant market share across the state, with UnitedHealthcare and Aetna providing additional options primarily in urban markets. This moderate level of insurer competition affects negotiated rates, with some rural parishes having limited insurer choices. The concentration of market power allows insurers to negotiate more aggressively with providers, though this doesn't always translate to lower patient costs.

Physician Supply and Demand in Louisiana

With 954 active EGD with Biopsy providers serving Louisiana's 4.6 million residents, the state maintains adequate specialist availability in urban areas but faces shortages in rural parishes. This supply concentration drives up wait times and costs in underserved regions, while urban markets like New Orleans maintain competitive pricing due to provider density. The ongoing physician shortage in rural Louisiana particularly affects access to specialized gastroenterology services.

JP

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 Louisiana

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

Uninsured patients in Louisiana typically pay between $85 and $634 for an EGD with Biopsy, with a median cost of $274 based on negotiated insurance rates. However, many providers offer cash-pay discounts of 20-40% for patients paying at the time of service. Community health centers and independent practices often provide more affordable options than hospital-based facilities.

Does Louisiana Medicaid cover EGD with Biopsy visits?

Louisiana has not expanded Medicaid, so coverage is limited to pregnant women, children, parents with very low incomes, and adults with disabilities. For those who qualify, Louisiana Medicaid covers medically necessary EGD with Biopsy procedures when prior authorization requirements are met. The restrictive eligibility leaves many low-income adults without Medicaid coverage options.

How do I find an affordable EGD with Biopsy near me in Louisiana?

Compare costs between hospital outpatient departments and independent gastroenterology practices, as facility fees can significantly increase total costs. Ask about self-pay discounts, payment plans, and consider community health centers in areas like New Orleans and Baton Rouge. Ambulatory surgery centers often offer more competitive pricing than hospital-based facilities.

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

Based on Louisiana pricing data, initial EGD consultations typically cost more than follow-up visits due to the comprehensive evaluation required for new patients. Follow-up visits for biopsy results or post-procedure care generally involve lower facility fees and shorter appointment times. The actual cost difference depends on your insurance plan's specialist visit structure and whether additional procedures are performed.

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

Yes, EGD with Biopsy visits qualify as medical expenses under both Health Savings Accounts and Flexible Spending Accounts. You can use these pre-tax dollars for copays, deductibles, and any portion not covered by insurance. Keep all receipts and documentation for tax purposes, as HSA funds roll over year to year while FSA funds typically must be used within the plan year.

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

While the actual endoscopy procedure requires an in-person visit, many Louisiana gastroenterologists offer telehealth consultations for initial evaluations and follow-up visits. These virtual visits typically cost $50-150 less than in-office consultations and can help determine if an EGD with biopsy is necessary. Louisiana expanded telehealth coverage during the pandemic, and many insurers continue to cover virtual gastroenterology consultations.

Click a state to compare costs

Average Visit Cost

$228
$2,029

Office visit (CPT 43239)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $116$5,357
$2,029
2North Dakota
Range: $181$2,396
$1,658
3Minnesota
Range: $90$2,396
$1,627
4South Dakota
Range: $85$2,396
$938
5Massachusetts
Range: $80$1,654
$747
6New York
Range: $166$1,647
$743
7New Hampshire
Range: $341$1,085
$715
8Rhode Island
Range: $80$1,647
$715
9Connecticut
Range: $85$1,647
$711
10Delaware
Range: $80$1,647
$684
11West Virginia
Range: $80$1,647
$675
12Pennsylvania
Range: $80$1,647
$666
13Maine
Range: $404$783
$631
14Nebraska
Range: $195$902
$629
15Oregon
Range: $80$1,352
$553
16Vermont
Range: $273$907
$552
17Wyoming
Range: $173$1,151
$549
18California
Range: $80$1,352
$542
19Georgia
Range: $85$1,084
$522
20Iowa
Range: $85$902
$516
21New Jersey
Range: $83$1,165
$508
22District of Columbia
Range: $86$995
$504
23North Carolina
Range: $80$1,088
$495
24Missouri
Range: $130$712
$436
25Utah
Range: $80$820
$428
26New Mexico
Range: $90$834
$424
27Washington
Range: $80$954
$423
28Hawaii
Range: $80$903
$411
29Maryland
Range: $121$810
$401
30Indiana
Range: $80$810
$399
31Colorado
Range: $85$829
$383
32Kentucky
Range: $60$830
$370
33Illinois
Range: $70$696
$368
34Arkansas
Range: $85$712
$361
35Virginia
Range: $90$728
$358
36Idaho
Range: $80$802
$356
37Michigan
Range: $80$685
$341
38Mississippi
Range: $114$621
$340
39Kansas
Range: $130$526
$333
40Louisiana
Range: $85$634
$331
41Texas
Range: $80$649
$320
42Ohio
Range: $85$621
$309
43South Carolina
Range: $80$627
$306
44Alabama
Range: $80$566
$305
45Nevada
Range: $85$571
$304
46Tennessee
Range: $85$604
$296
47Oklahoma
Range: $85$569
$264
48Alaska
Range: $80$606
$255
49Florida
Range: $35$659
$250
50Arizona
Range: $81$493
$245
51Montana
Range: $80$523
$228
Upper Endoscopy with Biopsy in Other States