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Idaho

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

National avg: $383Idaho: $316

18% below national average

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
Colonoscopy

Diagnostic colonoscopy

45378$80$273$735165
Colonoscopy with Biopsy

Colonoscopy with biopsy

45380$80$272$906186
Colonoscopy with Polyp Removal

Colonoscopy with polyp removal by snare

45385$80$400$3,638163
Upper Endoscopy with Biopsy

Upper GI endoscopy with biopsy

43239$80$188$802191
ECG / EKG

12-lead electrocardiogram with interpretation

93000$14$26$90383
Echocardiogram

Transthoracic echocardiogram with Doppler

93306$78$131$430189
OB Ultrasound

Obstetric ultrasound, complete

76805$50$85$591200

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 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.

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 Idaho

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

Uninsured patients in Idaho can expect to pay between $86 and $623 for an Upper Endoscopy procedure, with a median cost of $239 based on negotiated rates from 95 providers statewide. Many gastroenterology practices offer cash-pay discounts of 20-40% for patients who pay at the time of service, potentially reducing these costs significantly.

Does Idaho Medicaid cover Upper Endoscopy visits?

Yes, Idaho Medicaid covers medically necessary Upper Endoscopy procedures with no copays for most beneficiaries. The state's Medicaid expansion has improved access to gastroenterology services, though patients may need to travel to Boise or other urban areas where most specialists practice.

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

Compare costs between hospital-based endoscopy centers and independent gastroenterology practices, as independent facilities often offer lower overhead costs. Ask about cash-pay discounts if uninsured, and consider community health centers in cities like Boise or Coeur d'Alene that may offer sliding-scale fees based on income.

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

Based on Idaho's transparency data, Upper Endoscopy procedures themselves range from $86 to $623 with a median of $239. Initial consultations and follow-up visits are typically billed separately from the actual endoscopic procedure, with follow-up visits generally costing 20-30% less than comprehensive new patient evaluations.

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

Yes, Upper Endoscopy procedures qualify as eligible medical expenses for both Health Savings Accounts and Flexible Spending Accounts. You can use these pre-tax dollars for the procedure itself, related anesthesia costs, and any necessary biopsies or additional testing performed during the endoscopy.

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

While the actual Upper Endoscopy procedure must be performed in person, many Idaho gastroenterologists offer telemedicine consultations for initial evaluations and follow-up care. These virtual visits typically cost $100-200 less than in-person consultations and can help rural patients avoid travel costs while determining if an endoscopic procedure is necessary.

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