Cost of a EGD with Biopsy Visit
in Vermont
Reviewed by Momentary Medical Group West PC
Vermont's rural healthcare infrastructure, with limited specialist availability across the state's mountainous terrain, creates unique cost dynamics for specialized procedures. Patients seeking an EGD with Biopsy in Vermont typically pay between $273 and $907, with a median out-of-pocket cost of $476 based on negotiated insurance rates. With 339 active providers across Vermont offering EGD with Biopsy services, patients have options to compare costs and find quality care that fits their budget.
Average
$552
Median
$476
Lowest
$273
Highest
$907
Providers
339
3% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Vermont?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $106 | $347 | $801 | 334 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $317 | $537 | $1,042 | 337 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $333 | $553 | $1,096 | 337 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $211 | $362 | $673 | 325 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $11 | $18 | $73 | 352 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $61 | $171 | $471 | 348 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $124 | $341 | 337 |
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 Vermont
Vermont's healthcare costs run approximately 15% above the national average, driven by the state's rural geography and relatively small population spread across mountainous terrain. The concentration of specialists in the Burlington area creates cost disparities between urban and rural regions, with limited competition among providers in many areas.
Urban vs. Rural Provider Availability
Most of Vermont's gastroenterology specialists practice in the Burlington-South Burlington metropolitan area and along the Connecticut River Valley, leaving vast rural areas with limited access. Patients in remote areas like the Northeast Kingdom often travel significant distances for EGD procedures, potentially adding travel costs but sometimes finding lower procedure fees at rural hospitals.
Facility Type and Overhead Costs
Hospital-based outpatient clinics, particularly those affiliated with the University of Vermont Medical Center, typically charge higher facility fees than independent gastroenterology practices. Smaller community hospitals like those in Brattleboro or St. Albans may offer more competitive pricing while still maintaining quality standards for endoscopic procedures.
Insurance Market Competition in Vermont
With BCBS VT and MVP Health Care controlling the majority of the commercial insurance market, Vermont has limited insurer competition compared to larger states. This concentration can lead to stronger negotiating power with providers but may also result in fewer plan options and potentially higher premiums for specialized care coverage.
Physician Supply and Demand in Vermont
Vermont's 339 active EGD with Biopsy providers serve a population of approximately 645,000, creating a reasonable provider-to-patient ratio in urban areas but significant shortages in rural regions. This geographic maldistribution can lead to longer wait times in underserved areas and may drive some patients to seek care across state lines in New Hampshire or New York.
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 Vermont
What is the average cost of a EGD with Biopsy visit in Vermont without insurance?
Does Vermont Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Vermont?
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 Vermont?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Vermont?
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 |