Florida

Cost of a Upper Endoscopy Visit
in Florida

Name: Upper Endoscopy (EGD) Cost in Florida (2026)
Creator: Jayant Panwar
Published: 2026-03-18

Reviewed by Momentary Medical Group West PC

Florida leads the nation with the largest ambulatory surgery center market, creating competitive pricing for Upper Endoscopy procedures across the state. Patients typically pay between $35 and $496 for Upper Endoscopy visits, with a median negotiated rate of $55 among Florida's 4,488 active providers. Florida's extensive network of gastroenterology specialists and outpatient facilities offers patients multiple options for affordable Upper Endoscopy care throughout the state.

Average

$195

Median

$55

Lowest

$35

Highest

$496

Providers

4,488

National avg: $383Florida: $195

49% below national average

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Compare Similar Procedures

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

Procedure	CPT	Low	Median	High	Providers
Colonoscopy Diagnostic colonoscopy	45378	$35	$55	$604	5,123
Colonoscopy with Biopsy Colonoscopy with biopsy	45380	$35	$55	$770	5,449
Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare	45385	$35	$55	$815	4,958
Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy	43239	$35	$55	$659	5,570
ECG / EKG 12-lead electrocardiogram with interpretation	93000	$16	$40	$80	5,759
Echocardiogram Transthoracic echocardiogram with Doppler	93306	$60	$161	$460	4,125
OB Ultrasound Obstetric ultrasound, complete	76805	$35	$60	$192	5,349

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.

Full data methodology and glossary

Why Upper Endoscopy Visit Costs Vary Across Florida

Upper Endoscopy costs in Florida run approximately 2% above the national average, influenced by the state's extensive ambulatory surgery center infrastructure and competitive gastroenterology market. Florida's large retiree population and tourism industry create unique healthcare demand patterns that affect pricing and provider availability.

Urban vs. Rural Provider Availability

South Florida metros like Miami-Dade and Broward County offer abundant gastroenterology specialists and outpatient endoscopy centers, creating competitive pricing. Rural counties in North Florida and the Panhandle have fewer specialists, often requiring patients to travel to Gainesville, Tallahassee, or Jacksonville for procedures. This geographic disparity can increase total costs when factoring in travel and lost work time.

Facility Type and Overhead Costs

Florida's leadership in ambulatory surgery centers provides patients with lower-cost alternatives to hospital-based outpatient departments for Upper Endoscopy procedures. Major health systems like Baptist Health, AdventHealth, and HCA Florida operate extensive networks that may offer negotiated rates with insurers. Independent gastroenterology practices often provide more competitive cash-pay pricing than hospital-owned facilities.

Insurance Market Competition in Florida

The presence of major insurers UnitedHealthCare, Blue Cross Blue Shield of Florida, and Aetna creates moderate competition for negotiated rates with gastroenterology providers. Florida's large individual insurance market through the federal marketplace adds pricing pressure on providers to offer competitive rates. Regional insurers and Medicare Advantage plans also influence local pricing dynamics.

Physician Supply and Demand in Florida

With 4,488 providers offering Upper Endoscopy services, Florida maintains adequate specialist availability relative to its population and high demand from older residents. The state's appeal to retiring physicians helps maintain steady provider supply, though certain regions still experience shortages. Strong supply generally helps keep procedure costs competitive and reduces wait times for non-urgent cases.

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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 Florida

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

Uninsured patients in Florida typically pay between $35 and $496 for Upper Endoscopy procedures, with a median cost around $55 based on negotiated insurance rates. Cash-pay patients may receive discounts from these rates, especially at ambulatory surgery centers and independent practices. Many Florida providers offer payment plans or reduced self-pay pricing to make procedures more affordable for uninsured patients.

Does Florida Medicaid cover Upper Endoscopy visits?

Florida Medicaid covers medically necessary Upper Endoscopy procedures when performed by participating providers and approved through prior authorization. Since Florida has not expanded Medicaid, coverage is limited to specific qualifying categories rather than all low-income adults. Patients should verify their provider accepts Medicaid and obtain any required referrals before scheduling the procedure.

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

Compare prices between ambulatory surgery centers and hospital outpatient departments, as ASCs typically charge less for the same procedure. Ask about cash-pay discounts if you're uninsured or have a high-deductible plan, and consider community health centers or academic medical centers that may offer sliding fee scales. Momentary Lab can help you compare costs across thousands of Florida providers and check your specific insurance coverage instantly.

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

Initial Upper Endoscopy consultations typically cost more than follow-up visits due to the comprehensive evaluation required for new patients. The procedure itself represents the largest cost component at $35-496 in Florida, while pre- and post-procedure office visits are generally less expensive. Follow-up visits for discussing results or managing ongoing treatment usually involve lower facility and physician fees than the initial diagnostic procedure.

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

Upper Endoscopy procedures qualify as eligible medical expenses for both Health Savings Account and Flexible Spending Account reimbursement when medically necessary. You can use HSA or FSA funds to pay deductibles, copays, and coinsurance associated with the procedure. Keep all receipts and documentation from your Florida provider for reimbursement or tax purposes.

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

While Upper Endoscopy procedures require in-person care, initial consultations and follow-up visits can often be conducted via telemedicine in Florida. Virtual consultations typically cost less than in-office visits and may help you avoid unnecessary trips to the gastroenterologist's office. Many Florida providers expanded telehealth services and continue offering virtual options for appropriate clinical scenarios, though the actual endoscopy must be performed in a medical facility.

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Average Visit Cost