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Connecticut

Cost of a Upper Endoscopy Visit
in Connecticut

Reviewed by Momentary Medical Group West PC

Connecticut's healthcare costs run approximately 14% above the national average, reflecting the state's concentration of academic medical centers and specialty providers. For Upper Endoscopy procedures in Connecticut, patients typically pay between $117 and $683, with a median negotiated rate of $301 based on insurer agreements with 414 active providers statewide. Connecticut residents have access to Upper Endoscopy specialists across major health systems including Yale New Haven Health, Hartford HealthCare, and Trinity Health Of New England, with patients able to browse all providers throughout the state.

Average

$367

Median

$301

Lowest

$118

Highest

$683

Providers

414

National avg: $383Connecticut: $367

4% below national average

Compare Similar Procedures

How does upper endoscopy (egd) compare to related procedures in Connecticut?

ProcedureCPTLowMedianHighProviders
Colonoscopy

Diagnostic colonoscopy

45378$90$323$1,830426
Colonoscopy with Biopsy

Colonoscopy with biopsy

45380$85$475$2,117445
Colonoscopy with Polyp Removal

Colonoscopy with polyp removal by snare

45385$213$525$2,338437
Upper Endoscopy with Biopsy

Upper GI endoscopy with biopsy

43239$85$402$1,647461
ECG / EKG

12-lead electrocardiogram with interpretation

93000$14$63$931,940
Echocardiogram

Transthoracic echocardiogram with Doppler

93306$64$127$6771,444
OB Ultrasound

Obstetric ultrasound, complete

76805$45$70$328895

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 43235EGD, 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 Connecticut

Connecticut's healthcare costs run approximately 14% above the national average, driven by the state's high concentration of academic medical centers and its proximity to expensive metropolitan markets in New York and Boston. The small geographic size of the state means most residents have access to specialized care, but this concentration of high-end providers contributes to higher overall procedure costs.

Urban vs. Rural Provider Availability

Connecticut's urban corridors around Hartford, New Haven, and Bridgeport offer multiple gastroenterology options with competitive pricing, while residents in eastern Connecticut may have fewer choices and longer travel distances. The Quiet Corner region relies heavily on providers affiliated with Hartford HealthCare or Day Kimball Healthcare, which can limit competition. Most complex endoscopic procedures are concentrated in the I-95 and I-91 corridors where major health systems are located.

Facility Type and Overhead Costs

Connecticut's healthcare landscape is dominated by large health systems like Yale New Haven Health and Hartford HealthCare, whose hospital-based endoscopy centers typically charge higher facility fees than independent ambulatory surgery centers. Academic medical centers command premium pricing due to their teaching missions and research activities, while community hospitals and freestanding endoscopy centers often offer more competitive rates. The state's high real estate costs and labor expenses contribute to elevated overhead across all facility types.

Insurance Market Competition in Connecticut

Anthem, Cigna, and UnitedHealthcare compete actively in Connecticut's individual and group insurance markets, helping to moderate negotiated rates for specialist procedures like Upper Endoscopy. The state's Access Health CT marketplace offers multiple plan options, creating additional pressure on insurers to maintain competitive provider networks. However, Connecticut's small market size can limit insurers' negotiating power with large health systems, sometimes resulting in higher rates than in larger states.

Physician Supply and Demand in Connecticut

With 414 active Upper Endoscopy providers serving a population of 3.6 million, Connecticut has a relatively high density of gastroenterologists compared to national averages, particularly around major medical centers. This adequate supply helps maintain reasonable wait times for routine procedures, though highly specialized interventional endoscopy may still require longer scheduling lead times. The concentration of providers in urban areas means some patients in eastern Connecticut may face longer drives but generally have good access to quality care.

JP

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.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Upper Endoscopy Costs in Connecticut

What is the average cost of a Upper Endoscopy visit in Connecticut without insurance?

Without insurance, Upper Endoscopy procedures in Connecticut range from $117 to $683, with a median cost of $301 based on negotiated rates between insurers and providers. Self-pay patients may be able to negotiate discounts of 20-40% below these rates, especially at independent endoscopy centers. The final cost depends on the complexity of the procedure and whether it's performed at a hospital-based facility or ambulatory surgery center.

Does Connecticut Medicaid cover Upper Endoscopy visits?

Yes, Connecticut's expanded Medicaid program covers medically necessary Upper Endoscopy procedures when performed by qualified gastroenterologists. Prior authorization may be required for certain procedures, and coverage includes both diagnostic and therapeutic endoscopy when clinically indicated. Medicaid patients should verify that their chosen provider accepts Connecticut Medicaid, as participation rates vary among gastroenterology practices.

How do I find an affordable Upper Endoscopy near me in Connecticut?

Compare prices among independent ambulatory surgery centers, which often cost less than hospital-based facilities, and ask about self-pay discounts if you're uninsured. Community health centers like Fair Haven Community Health Care and Charter Oak Health Center may offer sliding-scale fees for qualifying patients. Consider traveling to eastern Connecticut where overhead costs are generally lower than in Fairfield County.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial gastroenterology consultations in Connecticut typically cost $200-400, while follow-up visits range from $150-250 depending on complexity and time spent. The actual Upper Endoscopy procedure ranges from $117-683 with a median of $301, representing the facility and physician fees combined. Many patients require both a consultation visit and a separate procedure appointment, so factor both costs into your planning.

Can I use an HSA or FSA to pay for a Upper Endoscopy visit in Connecticut?

Yes, Upper Endoscopy procedures qualify as eligible medical expenses for both Health Savings Accounts and Flexible Spending Accounts. This includes the physician fees, facility fees, anesthesia costs, and any pathology services related to the procedure. Keep all receipts and documentation, as you may need to provide proof that the procedure was medically necessary rather than cosmetic.

How does telemedicine affect the cost of seeing a Upper Endoscopy in Connecticut?

While Upper Endoscopy procedures must be performed in person, initial consultations with gastroenterologists can often be conducted via telemedicine at lower costs, typically $75-150 versus $200-400 for in-office visits. Connecticut expanded telehealth coverage during COVID-19, and many insurers continue to cover virtual consultations. However, most gastroenterologists will require an in-person visit before scheduling any endoscopic procedure.

Click a state to compare costs

Average Visit Cost

$195
$1,697

Office visit (CPT 43235)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $130$4,430
$1,697
2Massachusetts
Range: $159$1,259
$625
3New Hampshire
Range: $288$813
$547
4Maine
Range: $333$583
$493
5Nebraska
Range: $176$691
$487
6Iowa
Range: $135$691
$473
7North Dakota
Range: $118$853
$440
8Wyoming
Range: $161$864
$438
9Georgia
Range: $119$830
$433
10North Carolina
Range: $120$853
$424
11West Virginia
Range: $93$889
$419
12Vermont
Range: $211$673
$415
13Minnesota
Range: $117$695
$408
14Washington
Range: $152$759
$408
15Rhode Island
Range: $109$718
$406
16Utah
Range: $98$627
$405
17New York
Range: $159$771
$401
18New Mexico
Range: $141$724
$391
19District of Columbia
Range: $115$701
$387
20Alaska
Range: $105$759
$380
21Connecticut
Range: $118$683
$367
22Indiana
Range: $90$691
$361
23Delaware
Range: $109$701
$361
24Pennsylvania
Range: $90$715
$360
25South Dakota
Range: $103$691
$356
26Missouri
Range: $115$535
$354
27New Jersey
Range: $74$758
$354
28Oregon
Range: $85$691
$346
29Maryland
Range: $109$666
$337
30Hawaii
Range: $82$636
$331
31Colorado
Range: $117$627
$329
32Kentucky
Range: $106$631
$328
33Michigan
Range: $121$572
$322
34Idaho
Range: $86$623
$316
35Illinois
Range: $118$534
$314
36South Carolina
Range: $109$564
$305
37Montana
Range: $90$581
$301
38Arkansas
Range: $90$535
$299
39Nevada
Range: $197$467
$297
40Virginia
Range: $95$551
$291
41Mississippi
Range: $101$544
$291
42Alabama
Range: $98$500
$279
43Texas
Range: $90$508
$276
44Louisiana
Range: $96$484
$270
45Tennessee
Range: $101$473
$266
46Oklahoma
Range: $85$521
$263
47Kansas
Range: $115$411
$262
48California
Range: $80$598
$254
49Ohio
Range: $77$474
$249
50Arizona
Range: $71$455
$233
51Florida
Range: $35$496
$195
Upper Endoscopy (EGD) in Other States