Cost of a EGD with Biopsy Visit
in New York
Reviewed by Momentary Medical Group West PC
New York's healthcare costs run approximately 22% above the national average, reflecting the state's concentration of world-class medical facilities and high operational expenses. For an EGD with Biopsy, patients typically pay between $166 and $1,647, with a median out-of-pocket cost of $417 based on negotiated insurance rates across the state's 31,089 active providers. New York offers extensive provider networks spanning from Manhattan's prestigious medical centers to rural facilities in the North Country, giving patients multiple options to compare costs and find quality care.
Average
$743
Median
$417
Lowest
$166
Highest
$1,647
Providers
31,089
38% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in New York?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $101 | $298 | $1,830 | 30,995 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $241 | $488 | $2,117 | 31,059 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $276 | $507 | $2,338 | 30,991 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $159 | $274 | $771 | 30,910 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $10 | $16 | $63 | 32,178 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $51 | $171 | $895 | 31,068 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $36 | $112 | $328 | 31,848 |
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 York
New York's healthcare costs run 22% above the national average, driven by the state's high cost of living, extensive regulatory requirements, and concentration of academic medical centers that command premium rates. The state's geography creates distinct cost zones, from Manhattan's world-renowned medical facilities to more affordable options in upstate regions like the Capital District and Southern Tier.
Urban vs. Rural Provider Availability
New York City and Long Island feature dense concentrations of gastroenterologists, creating competitive pricing in some markets, while rural counties in the North Country and Finger Lakes regions may have limited specialist access requiring longer travel distances. The state's vast geographic diversity means patients in Albany or Syracuse often face different cost structures than those in the five boroughs, where real estate and labor costs significantly impact practice overhead.
Facility Type and Overhead Costs
Hospital-owned outpatient centers affiliated with major health systems like NewYork-Presbyterian, NYU Langone, and Mount Sinai typically charge facility fees that can double the total cost of EGD with Biopsy procedures compared to independent gastroenterology practices. These academic centers offer cutting-edge technology and subspecialty expertise but may not be cost-effective for routine diagnostic procedures that community providers can handle equally well.
Insurance Market Competition in New York
New York's insurance landscape includes strong competition between Empire BlueCross BlueShield, UnitedHealthcare, Aetna, and Cigna, along with regional plans like MVP Health Care serving upstate markets. This competitive environment has helped moderate premium increases, though the state's high medical costs still translate to above-average negotiated rates for specialist procedures like EGD with Biopsy.
Physician Supply and Demand in New York
With over 31,000 providers performing EGD with Biopsy procedures statewide, New York offers abundant specialist access in metropolitan areas, though distribution remains uneven with rural counties experiencing gastroenterologist shortages. This substantial provider network indicates healthy supply in urban markets, helping contain costs through competition, while underserved rural areas may face premium pricing due to limited options and longer wait 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 New York
What is the average cost of a EGD with Biopsy visit in New York without insurance?
Does New York Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in New York?
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 York?
How does telemedicine affect the cost of seeing a EGD with Biopsy in New York?
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 |