Cost of a EGD with Biopsy Visit
in Maryland
Reviewed by Momentary Medical Group West PC
Maryland's all-payer rate setting system creates more predictable hospital pricing than most states, yet outpatient specialist costs still vary significantly across the state's diverse healthcare landscape. For EGD with Biopsy procedures in Maryland, patients typically encounter negotiated insurance rates between $121 and $810, with a median cost of $273 based on data from over 4,000 active providers statewide. Maryland's robust network of gastroenterology specialists spans from Baltimore's academic medical centers to rural community hospitals on the Eastern Shore, giving patients multiple options to browse all providers throughout the state.
Average
$401
Median
$273
Lowest
$121
Highest
$810
Providers
4,050
25% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Maryland?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $162 | $312 | $712 | 4,015 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $175 | $373 | $919 | 4,048 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $226 | $423 | $1,002 | 3,987 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $109 | $236 | $666 | 3,944 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $18 | $37 | 4,160 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $55 | $161 | $398 | 4,085 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $37 | $90 | $231 | 4,026 |
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 Maryland
Maryland's healthcare costs run approximately 13% above the national average, driven by the state's proximity to high-cost Washington D.C. market and concentration of academic medical centers. The state's unique all-payer rate setting system creates hospital price transparency but doesn't extend to physician fees, leading to significant variation in EGD procedure costs across different practice settings.
Urban vs. Rural Provider Availability
Maryland's gastroenterology specialists cluster heavily in the Baltimore-Washington corridor, with over 70% of providers located within 50 miles of these urban centers. Rural counties on the Eastern Shore and in Western Maryland face significant access challenges, often requiring patients to travel 60+ miles for EGD procedures, which can increase overall care costs due to travel and time off work.
Facility Type and Overhead Costs
Hospital-owned gastroenterology practices dominate Maryland's market, with major health systems like Johns Hopkins, University of Maryland Medical System, and MedStar owning most endoscopy facilities. These hospital-affiliated centers typically charge higher facility fees than independent ambulatory surgery centers, contributing to Maryland's above-average procedure costs compared to states with more independent practice options.
Insurance Market Competition in Maryland
CareFirst BlueCross BlueShield holds significant market share in Maryland, particularly in individual and small group markets, creating less competitive pressure on negotiated rates than in states with more balanced insurer competition. UnitedHealthcare and Aetna provide additional options but with smaller networks, potentially limiting patient choice for in-network EGD providers in certain regions of the state.
Physician Supply and Demand in Maryland
With over 4,000 active EGD providers reported in transparency data, Maryland appears to have adequate gastroenterology capacity in urban areas, though this number likely includes multiple specialties performing endoscopy procedures. The concentration of providers in Baltimore and suburban Washington D.C. creates competitive pricing in these markets while leaving rural areas with limited options and potentially higher costs due to reduced competition.
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 Maryland
What is the average cost of a EGD with Biopsy visit in Maryland without insurance?
Does Maryland Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Maryland?
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 Maryland?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Maryland?
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 |