Cost of a Upper Endoscopy Visit
in District of Columbia
Reviewed by Momentary Medical Group West PC
As home to federal employees and one of the nation's most educated populations, District of Columbia maintains a concentrated healthcare market with costs running approximately 20% above national averages. Patients seeking an Upper Endoscopy procedure in DC typically pay between $114 and $701, with a median out-of-pocket cost of $345 based on negotiated insurance rates. With 315 active Upper Endoscopy providers across the district, patients have access to gastroenterologists at major medical centers like MedStar Georgetown and George Washington University Hospital, allowing you to browse all providers in District of Columbia for the best combination of quality and affordability.
Average
$387
Median
$345
Lowest
$115
Highest
$701
Providers
315
1% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in District of Columbia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $126 | $368 | $815 | 326 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $98 | $498 | $1,143 | 342 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $212 | $593 | $1,372 | 333 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $86 | $432 | $995 | 346 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $31 | $85 | 380 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $59 | $192 | $569 | 354 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $39 | $117 | $342 | 342 |
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 District of Columbia
District of Columbia's unique status as a federal district creates a healthcare market with costs running approximately 20% above national averages, driven by high real estate costs and a patient population with above-average income and insurance coverage. The concentrated geography means most residents have access to academic medical centers within a short distance, but this convenience comes with premium pricing.
Urban vs. Rural Provider Availability
As an entirely urban jurisdiction, District of Columbia offers excellent access to gastroenterology specialists, with most Upper Endoscopy procedures performed within a few miles of patients' homes. The compact geography eliminates the rural access challenges seen in other regions, but concentrates demand among a smaller number of high-cost providers.
Facility Type and Overhead Costs
Many Upper Endoscopy procedures in District of Columbia are performed at hospital outpatient departments associated with major health systems like MedStar Health and George Washington University Hospital, which typically charge higher facility fees than independent ambulatory surgery centers. The high cost of real estate and operations in the district contributes to elevated overhead expenses passed on to patients.
Insurance Market Competition in District of Columbia
The insurance market is relatively concentrated with CareFirst BCBS, UnitedHealthcare, and Aetna controlling most of the commercial market, limiting competitive pressure on negotiated rates. Federal employee health benefits plans provide additional market dynamics, often with more generous coverage that can support higher provider reimbursement rates.
Physician Supply and Demand in District of Columbia
With 315 active Upper Endoscopy providers serving a population of approximately 700,000 residents, District of Columbia has one of the highest gastroenterologist-to-population ratios in the country. This robust supply helps maintain reasonable wait times for procedures, though premium pricing persists due to the affluent patient population and high operating costs.
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 District of Columbia
What is the average cost of a Upper Endoscopy visit in District of Columbia without insurance?
Does District of Columbia Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in District of Columbia?
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 District of Columbia?
How does telemedicine affect the cost of seeing a Upper Endoscopy in District of Columbia?
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 |