Cost of a EGD with Biopsy Visit
in North Carolina
Reviewed by Momentary Medical Group West PC
North Carolina's growing ambulatory surgery center market has created more cost-effective options for patients needing specialized gastrointestinal procedures. For an EGD with Biopsy, patients typically pay between $80 and $1,088, with a median out-of-pocket cost of $318. With over 2,700 active EGD with Biopsy providers across the state, patients can browse all providers in North Carolina to find affordable care options.
Average
$495
Median
$318
Lowest
$80
Highest
$1,088
Providers
2,729
8% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in North Carolina?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $90 | $378 | $1,065 | 2,531 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $444 | $1,268 | 2,531 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $543 | $1,433 | 2,407 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $120 | $298 | $853 | 2,213 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $26 | $85 | 2,727 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $68 | $194 | $501 | 2,737 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $44 | $107 | $272 | 2,508 |
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 North Carolina
North Carolina's healthcare costs run approximately 2% below national averages, reflecting the state's mix of urban medical centers and rural communities with limited specialist access. The growing ambulatory surgery center market has introduced competitive pricing pressure on traditional hospital-based endoscopy services.
Urban vs. Rural Provider Availability
The Charlotte and Raleigh-Durham metro areas concentrate most gastroenterology specialists, while rural eastern and western counties often require patients to travel significant distances for EGD procedures. This geographic disparity creates cost variations as rural facilities may charge premium rates due to limited competition. Telemedicine consultations can reduce travel costs but cannot replace the need for in-person endoscopic procedures.
Facility Type and Overhead Costs
Hospital-based outpatient departments typically charge higher facility fees compared to independent ambulatory surgery centers throughout North Carolina. Major health systems like Atrium Health, Novant Health, and UNC Health have significant market presence, with their pricing power varying by regional competition. Freestanding endoscopy centers often offer more transparent pricing and faster scheduling.
Insurance Market Competition in North Carolina
Blue Cross Blue Shield of NC maintains the largest market share, followed by UnitedHealthcare and Aetna, creating moderate competition in urban areas. Rural counties may have limited insurer options, reducing negotiating power for competitive rates. The absence of Medicaid expansion limits insurer participation in some markets, affecting pricing dynamics for commercially insured patients.
Physician Supply and Demand in North Carolina
With over 2,700 active EGD with Biopsy providers statewide, North Carolina maintains adequate specialist supply in metropolitan areas but faces shortages in rural regions. This supply distribution creates pricing variations, with rural specialists potentially commanding higher rates due to limited alternatives. Urban competition helps moderate pricing while rural access challenges may increase travel and time costs 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 North Carolina
What is the average cost of a EGD with Biopsy visit in North Carolina without insurance?
Does North Carolina Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in North Carolina?
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 North Carolina?
How does telemedicine affect the cost of seeing a EGD with Biopsy in North Carolina?
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 |