Cost of a EGD with Biopsy Visit
in New Jersey
Reviewed by Momentary Medical Group West PC
New Jersey ranks among the top states for digestive health specialist density, with over 6,600 EGD with Biopsy providers serving residents across the Garden State. Patients seeking an EGD with Biopsy visit typically pay between $82.63 and $1,165.38, with a median out-of-pocket cost of $274.70 based on negotiated insurance rates. With numerous active providers from Princeton Medical Center to Atlantic Health System, patients can browse all qualified EGD with Biopsy specialists throughout New Jersey to find the right fit for their needs.
Average
$508
Median
$275
Lowest
$83
Highest
$1,165
Providers
6,615
6% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in New Jersey?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $110 | $289 | $1,117 | 6,562 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $120 | $349 | $1,329 | 6,606 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $151 | $404 | $1,496 | 6,545 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $74 | $229 | $758 | 6,513 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $25 | $68 | 7,374 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $60 | $164 | $490 | 6,620 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $35 | $83 | $244 | 7,282 |
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 New Jersey
New Jersey healthcare costs run approximately 17% above the national average, reflecting the state's high cost of living and proximity to major metropolitan areas like New York City and Philadelphia. The Garden State's dense population and extensive healthcare infrastructure create both competitive provider markets and premium pricing pressures.
Urban vs. Rural Provider Availability
New Jersey's compact geography means even rural areas have reasonable access to gastroenterology specialists, though the highest concentrations exist in the New York metropolitan corridor and around major medical centers like Princeton and Morristown. Southern New Jersey counties may require longer travel times to reach subspecialists, potentially affecting both costs and convenience. The state's excellent highway system helps minimize geographic access barriers compared to larger rural states.
Facility Type and Overhead Costs
Hospital-owned practices dominate New Jersey's gastroenterology landscape, with major systems like RWJBarnabas Health, Atlantic Health System, and Hackensack Meridian Health operating extensive outpatient networks. These hospital-affiliated providers often carry higher overhead costs that translate to premium pricing. Independent gastroenterology groups and ambulatory surgery centers provide alternative options with potentially lower facility fees.
Insurance Market Competition in New Jersey
Horizon Blue Cross Blue Shield holds significant market share in New Jersey, competing with national carriers like Aetna and UnitedHealthcare for both individual and employer group plans. This moderate concentration allows for competitive negotiated rates while maintaining network stability for patients. The state's proximity to New York and Pennsylvania also influences insurer competition and cross-border care patterns.
Physician Supply and Demand in New Jersey
With over 6,600 active EGD with Biopsy providers, New Jersey enjoys robust specialist availability that exceeds many states' per-capita ratios. This healthy supply helps contain costs through competition while reducing wait times for routine procedures. The concentration of medical schools and residency programs in the region supports continued specialist recruitment and retention.
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 New Jersey
What is the average cost of a EGD with Biopsy visit in New Jersey without insurance?
Does New Jersey Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in New Jersey?
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 New Jersey?
How does telemedicine affect the cost of seeing a EGD with Biopsy in New Jersey?
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 |