Cost of a EGD with Biopsy Visit
in Nebraska
Reviewed by Momentary Medical Group West PC
Nebraska's healthcare system serves a largely rural population across 93 counties, with EGD with Biopsy services concentrated primarily in Omaha, Lincoln, and regional medical centers. According to negotiated insurance rates, patients typically pay between $194.72 and $902.32 for these procedures, with a median out-of-pocket cost of $791.09. The state maintains 2,207 active providers offering EGD with Biopsy services, giving patients across Nebraska's agricultural communities and metro areas multiple options for accessing specialized gastrointestinal care.
Average
$629
Median
$791
Lowest
$195
Highest
$902
Providers
2,207
17% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Nebraska?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $265 | $701 | $815 | 2,194 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $281 | $904 | $1,040 | 2,198 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $360 | $946 | $1,090 | 2,193 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $176 | $594 | $691 | 2,182 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $37 | 2,654 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $101 | $283 | $477 | 2,203 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $82 | $117 | $329 | 2,648 |
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 Nebraska
Nebraska's healthcare costs run approximately 1% below national averages, reflecting the state's lower cost of living and moderate insurance market competition. The state's vast rural geography creates significant access challenges, with specialized gastroenterology services concentrated in Omaha, Lincoln, and a few regional medical centers serving the state's 1.9 million residents.
Urban vs. Rural Provider Availability
The Omaha-Council Bluffs metro area and Lincoln contain most of Nebraska's gastroenterology specialists, while rural counties often have no local access to EGD with Biopsy services. Patients in western Nebraska may travel 200+ miles to reach the nearest specialist, creating additional costs for lodging and lost work time that aren't reflected in procedure fees.
Facility Type and Overhead Costs
Hospital-based outpatient centers in Nebraska, particularly those affiliated with Nebraska Medicine in Omaha or Bryan Health in Lincoln, typically charge higher facility fees than independent endoscopy centers. Ambulatory surgery centers often provide the most cost-effective option for routine EGD with Biopsy procedures, with several operating in the state's major metropolitan areas.
Insurance Market Competition in Nebraska
Blue Cross Blue Shield of Nebraska dominates the state's insurance market, followed by UnitedHealthcare and Aetna, creating moderate competition that helps control negotiated rates. The limited number of major insurers means most gastroenterology practices accept the dominant plans, though rural providers may have more restrictive insurance acceptance due to lower patient volumes.
Physician Supply and Demand in Nebraska
With 2,207 providers offering EGD with Biopsy services across Nebraska, the state maintains adequate specialist availability in urban areas but faces shortages in rural regions. This supply-demand imbalance means rural patients often face longer wait times and higher costs due to limited local options, while Omaha and Lincoln offer competitive pricing and shorter appointment lead times.
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 Nebraska
What is the average cost of a EGD with Biopsy visit in Nebraska without insurance?
Does Nebraska Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Nebraska?
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 Nebraska?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Nebraska?
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 |