Cost of a EGD with Biopsy Visit
in Texas
Reviewed by Momentary Medical Group West PC
Texas operates one of the nation's largest healthcare markets with over 600 ambulatory surgery centers, creating competitive pricing for specialized procedures like EGD with Biopsy visits. Patients across the state typically pay between $80 and $649 for an EGD with Biopsy, with a median out-of-pocket cost of $230, reflecting rates that run approximately 4% below national averages. With over 12,600 active EGD with Biopsy providers throughout Texas, patients have extensive options when seeking care in major metros like Houston, Dallas, Austin, and San Antonio, as well as in smaller communities across the state's diverse regions.
Average
$320
Median
$230
Lowest
$80
Highest
$649
Providers
12,607
41% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Texas?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $291 | $634 | 10,832 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $332 | $772 | 11,638 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $90 | $402 | $866 | 10,759 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $90 | $230 | $508 | 10,361 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $25 | $90 | 14,138 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $155 | $418 | 12,962 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $46 | $96 | $237 | 11,056 |
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 Texas
Texas maintains healthcare costs approximately 4% below national averages for EGD with Biopsy procedures, benefiting from the state's large provider network and competitive market dynamics. The state's expansive geography creates distinct cost patterns, with major metropolitan areas offering the most competitive pricing due to provider density and insurer competition.
Urban vs. Rural Provider Availability
Texas's major metros like Houston, Dallas-Fort Worth, Austin, and San Antonio concentrate most EGD with Biopsy specialists, creating competitive pricing and shorter wait times. Rural counties across East Texas, the Panhandle, and South Texas often require patients to travel significant distances for endoscopy services, sometimes leading to higher total costs when factoring in travel expenses.
Facility Type and Overhead Costs
Texas's robust ambulatory surgery center network provides cost-effective alternatives to hospital-based endoscopy services, with ASCs typically charging 20-40% less for EGD with Biopsy procedures. Major health systems like Houston Methodist, Baylor Scott & White, and UT Southwestern operate extensive networks that can leverage economies of scale to offer competitive pricing.
Insurance Market Competition in Texas
The presence of multiple major insurers including UnitedHealthcare, Blue Cross Blue Shield of Texas, Aetna, and Cigna creates robust competition that helps negotiate favorable rates for EGD with Biopsy procedures. Texas's large population and diverse market prevent any single insurer from dominating pricing negotiations, benefiting patients through lower out-of-pocket costs.
Physician Supply and Demand in Texas
With over 12,600 active EGD with Biopsy providers across Texas, the state maintains adequate specialist supply relative to its large population. This healthy provider-to-patient ratio helps keep wait times reasonable and prevents the artificial price inflation seen in markets with physician shortages, though distribution remains concentrated in urban areas.
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 Texas
What is the average cost of a EGD with Biopsy visit in Texas without insurance?
Does Texas Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Texas?
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 Texas?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Texas?
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 |