Cost of a Upper Endoscopy Visit
in Idaho
Reviewed by Momentary Medical Group West PC
Idaho's rural healthcare landscape and Medicaid expansion have created unique cost patterns for gastroenterology services across the state's 44 counties. Patients seeking Upper Endoscopy procedures typically pay between $86 and $623, with a median negotiated rate of $239 based on transparency data from 95 active providers throughout Idaho. The state's concentration of specialists in Boise, Coeur d'Alene, and Idaho Falls means patients in rural areas may face longer travel times but potentially lower costs than neighboring states like Washington or Oregon.
Average
$316
Median
$239
Lowest
$86
Highest
$623
Providers
95
18% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Idaho?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $80 | $273 | $735 | 165 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $272 | $906 | 186 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $400 | $3,638 | 163 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $188 | $802 | 191 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $26 | $90 | 383 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $78 | $131 | $430 | 189 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $85 | $591 | 200 |
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 Idaho
Idaho's healthcare costs run approximately 3% below national averages, reflecting the state's rural character and lower overhead costs outside major metropolitan areas. The state's geographic isolation from major medical centers in Seattle or Salt Lake City creates both cost advantages and access challenges for specialty gastroenterology services.
Urban vs. Rural Provider Availability
Most of Idaho's gastroenterologists practice in the Treasure Valley around Boise or in Coeur d'Alene, creating significant travel requirements for patients in rural counties like Lemhi or Owyhee. This concentration drives down costs in urban areas through competition while potentially increasing expenses for rural patients who must travel for procedures.
Facility Type and Overhead Costs
Saint Alphonsus and St. Luke's health systems operate most hospital-based endoscopy centers in Idaho, while independent gastroenterology practices offer alternatives in cities like Idaho Falls and Twin Falls. Independent facilities typically have lower overhead costs and may offer more competitive pricing for cash-pay patients.
Insurance Market Competition in Idaho
The dominance of Regence BlueCross and PacificSource in Idaho's individual and small group markets creates a relatively stable but less competitive insurance environment. This concentration allows these insurers to negotiate favorable rates with providers, though it also means fewer plan options for consumers seeking different coverage structures.
Physician Supply and Demand in Idaho
With 95 providers offering Upper Endoscopy services across Idaho, the state maintains adequate specialist coverage relative to its population, though geographic distribution remains uneven. This supply-demand balance helps keep costs reasonable compared to states with significant specialist shortages, while the rural nature of much of Idaho prevents the premium pricing seen in major metropolitan markets.
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 Idaho
What is the average cost of a Upper Endoscopy visit in Idaho without insurance?
Does Idaho Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Idaho?
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 Idaho?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Idaho?
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 |
