Cost of a EGD with Biopsy Visit
in Michigan
Reviewed by Momentary Medical Group West PC
Michigan's healthcare system serves over 10 million residents through a network that spans from Detroit's major medical centers to rural Upper Peninsula communities. Patients seeking an EGD with Biopsy in Michigan typically pay between $80 and $685, with a median out-of-pocket cost of $259 based on negotiated insurance rates. The state maintains 2,142 active EGD with Biopsy providers across urban and rural areas, giving patients multiple options to find quality care at different price points throughout Michigan.
Average
$341
Median
$259
Lowest
$80
Highest
$685
Providers
2,142
37% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Michigan?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $92 | $327 | $768 | 1,803 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $393 | $887 | 2,214 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $467 | $1,088 | 2,038 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $121 | $274 | $572 | 1,673 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $15 | $21 | $95 | 2,698 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $67 | $166 | $405 | 2,196 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $88 | $216 | 2,133 |
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 Michigan
Michigan's EGD with Biopsy costs run approximately 36% below national averages, reflecting the state's moderate cost of living and competitive insurance market. The state's unique geography, stretching from Detroit's urban density to the rural Upper Peninsula, creates significant disparities in provider access and healthcare pricing across regions.
Urban vs. Rural Provider Availability
Michigan's 2,142 EGD with Biopsy providers are concentrated in metro Detroit, Grand Rapids, and Ann Arbor, while rural counties in northern Michigan and the Upper Peninsula have limited specialist access. This geographic maldistribution means patients in remote areas may travel 2-3 hours for procedures, but often find lower facility fees at smaller regional hospitals compared to Detroit's major medical centers.
Facility Type and Overhead Costs
Hospital-based outpatient clinics affiliated with systems like Beaumont, Henry Ford, and University of Michigan typically charge higher facility fees than independent gastroenterology practices. Ambulatory surgery centers have grown rapidly in Michigan's suburban markets, offering EGD with Biopsy procedures at competitive rates with shorter wait times than hospital-based facilities.
Insurance Market Competition in Michigan
Blue Cross Blue Shield of Michigan maintains the largest market share but faces strong competition from UnitedHealthcare and Aetna, creating negotiated rate pressure that benefits patients. The state's relatively concentrated insurer market gives these major players significant leverage in rate negotiations with providers, contributing to Michigan's below-national average costs.
Physician Supply and Demand in Michigan
With 2,142 active providers offering EGD with Biopsy services, Michigan maintains adequate specialist supply in urban areas but faces shortages in rural regions. This supply-demand imbalance means competitive pricing in metro markets like Detroit and Grand Rapids, while rural areas may have higher costs due to limited provider options and longer travel distances for patients.
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 Michigan
What is the average cost of a EGD with Biopsy visit in Michigan without insurance?
Does Michigan Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Michigan?
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 Michigan?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Michigan?
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 |