Cost of a EGD with Biopsy Visit
in Tennessee
Reviewed by Momentary Medical Group West PC
Tennessee's healthcare system serves over 6.9 million residents through a mix of urban medical centers and rural hospitals, with particularly strong gastroenterology networks in Nashville, Memphis, and Knoxville. For patients needing a EGD with Biopsy visit, costs typically range from $85 to $604, with a median out-of-pocket expense of $200 based on negotiated insurance rates across the state's 2,698 active providers. Tennessee residents can browse all available EGD with Biopsy specialists to find the most affordable option in their area.
Average
$296
Median
$200
Lowest
$85
Highest
$604
Providers
2,698
45% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Tennessee?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $90 | $288 | $582 | 2,610 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $314 | $714 | 2,664 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $90 | $399 | $796 | 2,520 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $101 | $223 | $473 | 2,452 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $18 | $85 | 2,824 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $165 | $340 | 2,797 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $48 | $104 | $189 | 2,512 |
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 Tennessee
Tennessee's healthcare costs run approximately 4% below national averages, benefiting from lower overall cost of living compared to coastal states and moderate competition among major insurers. The state's geography creates distinct cost patterns, with urban centers like Nashville commanding higher rates while rural Appalachian regions often struggle with provider shortages.
Urban vs. Rural Provider Availability
Tennessee's EGD with Biopsy specialists concentrate heavily in the Nashville, Memphis, and Knoxville metropolitan areas, leaving rural counties in East and West Tennessee with limited options and longer travel distances. This geographic disparity often forces rural patients to seek care in urban centers, where facility fees and overhead costs drive up total visit expenses.
Facility Type and Overhead Costs
Hospital-owned gastroenterology practices in Tennessee, particularly those affiliated with major systems like HCA Healthcare, Vanderbilt, or Methodist Le Bonheur, typically charge facility fees on top of physician services. Independent gastroenterology groups and ASCs (Ambulatory Surgery Centers) often provide more cost-effective options for routine EGD with Biopsy consultations without compromising quality of care.
Insurance Market Competition in Tennessee
The Tennessee insurance market features moderate competition with BlueCross BlueShield of Tennessee holding significant market share alongside UnitedHealthcare and Cigna, preventing the extreme rate variations seen in less competitive states. However, the absence of Medicaid expansion limits insurer participation in certain markets, particularly affecting negotiated rates in rural counties.
Physician Supply and Demand in Tennessee
With 2,698 active EGD with Biopsy providers serving Tennessee's 6.9 million residents, the state maintains adequate specialist availability in urban areas while facing shortages in rural regions. This supply-demand imbalance contributes to longer wait times and potentially higher costs in underserved areas, though telehealth options are increasingly helping bridge these gaps.
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 Tennessee
What is the average cost of a EGD with Biopsy visit in Tennessee without insurance?
Does Tennessee Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Tennessee?
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 Tennessee?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Tennessee?
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 |