Cost of a EGD with Biopsy Visit
in Montana
Reviewed by Momentary Medical Group West PC
Montana's vast rural geography and physician shortages create unique challenges for accessing specialist care, with many residents traveling hours for procedures. For patients needing an EGD with Biopsy in Montana, negotiated insurance rates typically range from $80 to $523, with a median cost of $80 based on transparency data from 327 active providers. Browse all EGD with Biopsy providers across Montana to find the most affordable option in your area.
Average
$228
Median
$80
Lowest
$80
Highest
$523
Providers
327
58% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Montana?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $80 | $80 | $538 | 319 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $80 | $545 | 315 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $80 | $3,638 | 307 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $90 | $231 | $581 | 40 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $80 | 367 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $80 | $80 | $269 | 318 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $51 | $68 | $991 | 354 |
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 Montana
Montana's healthcare costs run approximately 4% above the national average, driven by the state's rural geography and limited provider competition. The Treasure State's vast distances between population centers create unique access challenges that affect both availability and pricing of specialized procedures.
Urban vs. Rural Provider Availability
Most of Montana's gastroenterologists practice in Billings, Missoula, Great Falls, and Bozeman, leaving large swaths of the eastern plains and mountain regions underserved. Rural patients often drive 2-3 hours to reach the nearest specialist, with some choosing procedures in neighboring states like North Dakota or Colorado. This geographic concentration allows urban providers to maintain higher prices due to limited local competition.
Facility Type and Overhead Costs
Hospital-owned facilities dominate Montana's specialist market, with major health systems like Billings Clinic and Providence Health & Services controlling much of the gastroenterology capacity. These hospital-affiliated providers typically charge facility fees on top of physician fees, increasing total procedure costs compared to independent ambulatory surgery centers. The high overhead costs of maintaining rural outreach and covering emergency call responsibilities also contribute to higher pricing structures.
Insurance Market Competition in Montana
Blue Cross Blue Shield of Montana holds the largest market share, followed by PacificSource and United Healthcare, with minimal competition in many rural counties. This limited insurer competition results in fewer negotiated rate variations compared to states with more robust insurance markets. Many Montana providers maintain similar contracted rates across the major insurers, reducing price competition and keeping costs elevated.
Physician Supply and Demand in Montana
With 327 providers performing EGD with Biopsy procedures statewide, Montana maintains adequate specialist coverage for its population, though geographic distribution remains heavily skewed toward urban areas. The state's aging population and increased demand for colorectal cancer screening has created longer wait times for routine procedures, allowing providers to maintain premium pricing. Recruitment of new gastroenterologists to rural areas remains challenging due to call obligations and lower patient volumes.
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 Montana
What is the average cost of a EGD with Biopsy visit in Montana without insurance?
Does Montana Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Montana?
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 Montana?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Montana?
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 |