Cost of a EGD with Biopsy Visit
in Washington
Reviewed by Momentary Medical Group West PC
Washington state's unique healthcare delivery system, anchored by major medical centers in Seattle and Spokane alongside extensive rural networks, creates significant variation in EGD with Biopsy procedure costs. Patients typically pay between $80 and $954 for this diagnostic procedure, with a median cost of $236 based on negotiated insurance rates. Washington maintains over 5,500 active providers offering EGD with Biopsy services across the state, from urban gastroenterology centers to critical access hospitals serving remote communities.
Average
$423
Median
$236
Lowest
$80
Highest
$954
Providers
5,547
21% below national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in Washington?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $80 | $298 | $856 | 5,559 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $385 | $1,143 | 4,616 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $487 | $3,638 | 4,541 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $152 | $312 | $759 | 2,247 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $16 | $80 | 5,856 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $80 | $185 | $513 | 4,713 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $51 | $92 | $991 | 5,465 |
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 Washington
Washington's healthcare costs run approximately 10% above national averages, driven by the state's concentrated urban markets and extensive rural geography requiring specialized provider networks. The Puget Sound region's high cost of living translates directly into elevated facility overhead and physician compensation compared to eastern Washington communities.
Urban vs. Rural Provider Availability
Seattle and Spokane concentrate most of Washington's gastroenterology specialists, creating access challenges for patients in rural counties who may travel 100+ miles for EGD with Biopsy procedures. Eastern Washington relies heavily on traveling specialists and telemedicine consultations, though actual endoscopic procedures still require in-person visits. Rural critical access hospitals often partner with urban specialists to provide periodic endoscopy clinics in underserved communities.
Facility Type and Overhead Costs
Hospital-owned endoscopy centers in Washington typically charge 30-50% more than independent surgery centers due to higher overhead and staffing requirements. Major health systems like UW Medicine, MultiCare, and Providence dominate the Washington market, potentially reducing price competition through consolidated ownership. Ambulatory surgery centers offer cost advantages but may have limited capacity for complex cases requiring hospital backup.
Insurance Market Competition in Washington
Washington maintains moderate insurer competition with Premera, Regence, Kaiser, and UHC controlling most of the commercial market, creating negotiated rate variations for EGD with Biopsy procedures. The state's insurance commissioner actively regulates rate increases, potentially constraining extreme price variations compared to less regulated markets. Washington's state employee health plan serves as a major purchaser, influencing regional pricing benchmarks for endoscopic procedures.
Physician Supply and Demand in Washington
Washington's 5,500+ providers offering EGD with Biopsy services suggests adequate supply in urban areas, though rural regions face ongoing specialist shortages. The University of Washington's medical training programs help maintain physician supply, but many graduates migrate to higher-paying markets outside the Pacific Northwest. Strong provider supply in Seattle creates competitive pricing pressure, while rural areas may see premium pricing due to limited alternatives.
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 Washington
What is the average cost of a EGD with Biopsy visit in Washington without insurance?
Does Washington Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in Washington?
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 Washington?
How does telemedicine affect the cost of seeing a EGD with Biopsy in Washington?
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 |