Cost of a EGD with Biopsy Visit
in West Virginia
Reviewed by Momentary Medical Group West PC
West Virginia faces one of the nation's highest rates of gastrointestinal cancers, making EGD with Biopsy procedures particularly important for early detection and diagnosis. Patients seeking an EGD with Biopsy in West Virginia typically pay between $80 and $1,647, with a median out-of-pocket cost of $298. West Virginia has 122 active providers offering these services across the state, allowing patients to browse all available EGD with Biopsy specialists throughout the Mountain State.
Average
$675
Median
$298
Lowest
$80
Highest
$1,647
Providers
122
25% above national average
Compare Similar Procedures
How does upper endoscopy with biopsy compare to related procedures in West Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $357 | $1,395 | 106 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $308 | $1,329 | 163 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $98 | $410 | $1,538 | 153 |
| Upper Endoscopy (EGD) Diagnostic upper GI endoscopy | 43235 | $93 | $274 | $889 | 98 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $91 | 304 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $66 | $155 | $1,167 | 201 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $68 | $215 | 208 |
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 West Virginia
West Virginia's healthcare costs run approximately 2% below national averages, reflecting the state's rural economy and lower cost of living compared to coastal regions. However, limited specialist availability in many counties can create access challenges that offset some of these cost advantages.
Urban vs. Rural Provider Availability
Charleston, Morgantown, and Huntington concentrate most of West Virginia's gastroenterology specialists, while 35 counties have no resident gastroenterologist. Patients in rural areas often face higher travel costs and may pay premium rates at hospital-based facilities that serve as regional referral centers. Telehealth consultations are increasingly used for follow-up visits, though the procedure itself requires in-person care.
Facility Type and Overhead Costs
Hospital-owned outpatient departments typically charge 30-50% more for EGD with Biopsy procedures than independent endoscopy centers due to higher overhead and facility fees. West Virginia University Medicine, Charleston Area Medical Center, and Cabell Huntington Hospital operate many of the state's endoscopy facilities. Independent gastroenterology practices often provide more competitive pricing but may have limited evening or weekend availability.
Insurance Market Competition in West Virginia
Highmark West Virginia dominates the individual and small group markets, while UnitedHealthcare and Aetna compete primarily in the large employer segment. Limited insurer competition reduces negotiating pressure on provider rates, potentially keeping specialist fees stable but not necessarily low. The state's small population and rural geography make it challenging for new insurers to enter the market profitably.
Physician Supply and Demand in West Virginia
With 122 providers offering EGD with Biopsy services statewide, West Virginia maintains adequate specialist coverage in urban areas but faces shortages in rural regions. The state's aging population and high rates of gastrointestinal conditions create strong demand for endoscopic procedures. Wait times for non-urgent EGD appointments can extend 4-8 weeks in some areas, though urgent cases are typically accommodated more quickly.
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 West Virginia
What is the average cost of a EGD with Biopsy visit in West Virginia without insurance?
Does West Virginia Medicaid cover EGD with Biopsy visits?
How do I find an affordable EGD with Biopsy near me in West Virginia?
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 West Virginia?
How does telemedicine affect the cost of seeing a EGD with Biopsy in West Virginia?
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 |