Cost of a EGD with Biopsy Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's concentrated healthcare market, dominated by a few major health systems, creates distinct pricing patterns for specialty procedures like EGD with Biopsy. Patients typically pay between $80 and $1,647 for an EGD with Biopsy visit, with a median negotiated rate of $418 among the state's 83 active providers. Rhode Island's small geographic footprint allows patients access to multiple EGD with Biopsy specialists within reasonable driving distance, and you can browse all available providers throughout the state.
Average
$715
Median
$418
Lowest
$80
Highest
$1,647
Providers
83
33% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $91 | $423 | $1,830 | 63 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $535 | $2,117 | 77 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $673 | $2,338 | 75 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $109 | $391 | $718 | 58 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $28 | $90 | 108 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $207 | $895 | 90 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $115 | $328 | 80 |
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 Rhode Island
Rhode Island's healthcare costs run approximately 13% above the national average, reflecting the state's high cost of living and concentrated provider market. The Ocean State's small size creates unique dynamics where patients can easily access multiple health systems, yet limited competition keeps prices elevated.
Urban vs. Rural Provider Availability
Most EGD with Biopsy specialists concentrate in the Providence-Warwick metropolitan area, with fewer options in South County and western Rhode Island communities. Rural residents often travel to Providence or Newport for specialized gastroenterology care, though the state's compact geography keeps drive times manageable under an hour.
Facility Type and Overhead Costs
Hospital-owned gastroenterology practices dominate Rhode Island's landscape, with major systems like Lifespan and Care New England operating multiple locations. Independent endoscopy centers offer lower facility fees but are less common, contributing to the state's above-average procedure costs compared to markets with more freestanding facilities.
Insurance Market Competition in Rhode Island
The limited presence of major insurers beyond Blue Cross Blue Shield of Rhode Island, UnitedHealthcare, and Tufts Health Plan reduces competitive pressure on negotiated rates. This concentrated market allows providers to maintain higher prices, particularly affecting self-pay patients who lack the negotiating power of large insurance networks.
Physician Supply and Demand in Rhode Island
With 83 active EGD with Biopsy providers serving a population of just over one million, Rhode Island maintains adequate specialist availability relative to its size. The steady supply helps prevent extreme price premiums from physician shortages, though demand from neighboring Massachusetts and Connecticut patients can create scheduling pressures at popular practices.
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 Rhode Island
What is the average cost of a EGD with Biopsy visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Rhode Island?
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 Rhode Island?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Rhode Island?
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 |