Cost of a Upper Endoscopy Visit
in California
Reviewed by Momentary Medical Group West PC
California's extensive network of gastroenterology centers and teaching hospitals provides patients with over 6,100 Upper Endoscopy providers across the state's diverse healthcare landscape. Patients typically pay between $80 and $598 for an Upper Endoscopy procedure, with negotiated rates running significantly below national averages at a median of $85. The state's competitive insurance market and high provider density create favorable pricing conditions, allowing patients to browse thousands of qualified Upper Endoscopy specialists throughout California.
Average
$254
Median
$85
Lowest
$80
Highest
$598
Providers
6,177
34% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in California?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $85 | $647 | 5,883 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $308 | $1,785 | 12,256 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $30 | $453 | $1,785 | 9,290 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $196 | $1,352 | 16,316 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $16 | $49 | $88 | 22,603 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $79 | $101 | $586 | 17,572 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $52 | $90 | $287 | 7,619 |
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 43235 — EGD, diagnostic). 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 43235 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 43235 (EGD, diagnostic), as mandated by the CMS Price Transparency Rule.
What CPT 43235 covers: the provider's professional fee for upper endoscopy (egd). 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 Upper Endoscopy Visit Costs Vary Across California
California's healthcare costs run approximately 18% above national averages, reflecting the state's high cost of living and robust provider networks. The state's diverse geography creates distinct regional markets from high-cost urban centers to more affordable rural communities.
Urban vs. Rural Provider Availability
California's major metropolitan areas like Los Angeles, San Francisco, and San Diego offer abundant Upper Endoscopy providers and competitive pricing, while rural counties in the Central Valley and Northern California may have limited specialist access. Patients in remote areas sometimes travel hundreds of miles for procedures, though telemedicine consultations help bridge some access gaps.
Facility Type and Overhead Costs
Hospital-based outpatient departments in California typically charge more for Upper Endoscopy procedures than independent ambulatory surgery centers due to higher facility fees and overhead costs. Major health systems like Sutter Health, Dignity Health, and UCLA Health operate extensive networks that can offer coordination benefits but may have higher baseline costs.
Insurance Market Competition in California
California's competitive insurance market includes dominant players Anthem Blue Cross, Kaiser Permanente, and UnitedHealthcare, along with regional plans like Health Net and Blue Shield. This competition helps keep negotiated rates reasonable for Upper Endoscopy procedures, though Kaiser's integrated model creates a unique cost structure compared to traditional insurers.
Physician Supply and Demand in California
With over 6,100 Upper Endoscopy providers statewide, California maintains robust specialist availability relative to its population, particularly in urban areas. This healthy supply helps contain costs and reduces wait times, though geographic distribution favors metropolitan regions over rural counties where specialist shortages can drive up prices.
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 — Upper Endoscopy Costs in California
What is the average cost of a Upper Endoscopy visit in California without insurance?
Does California Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in California?
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 Upper Endoscopy visit in California?
How does telemedicine affect the cost of seeing a Upper Endoscopy in California?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 43235)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $130 – $4,430 | $1,697 |
| 2 | Massachusetts Range: $159 – $1,259 | $625 |
| 3 | New Hampshire Range: $288 – $813 | $547 |
| 4 | Maine Range: $333 – $583 | $493 |
| 5 | Nebraska Range: $176 – $691 | $487 |
| 6 | Iowa Range: $135 – $691 | $473 |
| 7 | North Dakota Range: $118 – $853 | $440 |
| 8 | Wyoming Range: $161 – $864 | $438 |
| 9 | Georgia Range: $119 – $830 | $433 |
| 10 | North Carolina Range: $120 – $853 | $424 |
| 11 | West Virginia Range: $93 – $889 | $419 |
| 12 | Vermont Range: $211 – $673 | $415 |
| 13 | Minnesota Range: $117 – $695 | $408 |
| 14 | Washington Range: $152 – $759 | $408 |
| 15 | Rhode Island Range: $109 – $718 | $406 |
| 16 | Utah Range: $98 – $627 | $405 |
| 17 | New York Range: $159 – $771 | $401 |
| 18 | New Mexico Range: $141 – $724 | $391 |
| 19 | District of Columbia Range: $115 – $701 | $387 |
| 20 | Alaska Range: $105 – $759 | $380 |
| 21 | Connecticut Range: $118 – $683 | $367 |
| 22 | Indiana Range: $90 – $691 | $361 |
| 23 | Delaware Range: $109 – $701 | $361 |
| 24 | Pennsylvania Range: $90 – $715 | $360 |
| 25 | South Dakota Range: $103 – $691 | $356 |
| 26 | Missouri Range: $115 – $535 | $354 |
| 27 | New Jersey Range: $74 – $758 | $354 |
| 28 | Oregon Range: $85 – $691 | $346 |
| 29 | Maryland Range: $109 – $666 | $337 |
| 30 | Hawaii Range: $82 – $636 | $331 |
| 31 | Colorado Range: $117 – $627 | $329 |
| 32 | Kentucky Range: $106 – $631 | $328 |
| 33 | Michigan Range: $121 – $572 | $322 |
| 34 | Idaho Range: $86 – $623 | $316 |
| 35 | Illinois Range: $118 – $534 | $314 |
| 36 | South Carolina Range: $109 – $564 | $305 |
| 37 | Montana Range: $90 – $581 | $301 |
| 38 | Arkansas Range: $90 – $535 | $299 |
| 39 | Nevada Range: $197 – $467 | $297 |
| 40 | Virginia Range: $95 – $551 | $291 |
| 41 | Mississippi Range: $101 – $544 | $291 |
| 42 | Alabama Range: $98 – $500 | $279 |
| 43 | Texas Range: $90 – $508 | $276 |
| 44 | Louisiana Range: $96 – $484 | $270 |
| 45 | Tennessee Range: $101 – $473 | $266 |
| 46 | Oklahoma Range: $85 – $521 | $263 |
| 47 | Kansas Range: $115 – $411 | $262 |
| 48 | California Range: $80 – $598 | $254 |
| 49 | Ohio Range: $77 – $474 | $249 |
| 50 | Arizona Range: $71 – $455 | $233 |
| 51 | Florida Range: $35 – $496 | $195 |