Cost of a Upper Endoscopy Visit
in Illinois
Reviewed by Momentary Medical Group West PC
Illinois operates one of the most concentrated healthcare markets in the Midwest, with Chicago's medical district anchoring a network of over 3,600 Upper Endoscopy providers statewide. Patients across Illinois typically pay between $117 and $534 for Upper Endoscopy procedures, with a median out-of-pocket cost of $289 according to negotiated insurance rates. Browse all active Upper Endoscopy providers throughout Illinois to compare costs and find the best option for your specific insurance plan.
Average
$314
Median
$290
Lowest
$118
Highest
$534
Providers
3,608
18% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Illinois?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $344 | $901 | 4,773 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $441 | $1,147 | 4,920 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $220 | $462 | $944 | 5,408 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $70 | $339 | $696 | 5,884 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $17 | $24 | $85 | 10,197 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $74 | $178 | $378 | 6,654 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $45 | $101 | $257 | 6,504 |
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 Illinois
Illinois healthcare costs run approximately 10% above national averages, driven primarily by Chicago's concentration of academic medical centers and suburban sprawl that limits competition. The state's mix of urban density in Cook County and rural counties creates stark disparities in both provider access and pricing for specialized procedures like Upper Endoscopy.
Urban vs. Rural Provider Availability
Chicago and its collar counties house the majority of Illinois's 3,600 Upper Endoscopy providers, while rural areas south of Interstate 80 often require patients to travel over an hour for specialized gastroenterology care. This geographic maldistribution allows urban providers to maintain higher prices due to convenience, while rural patients face additional travel costs that effectively increase their total procedure expense.
Facility Type and Overhead Costs
Hospital-owned endoscopy suites in Illinois charge facility fees that can double the total procedure cost compared to independent ambulatory surgery centers. Major health systems like Northwestern Medicine, Rush, and University of Chicago Medicine command premium pricing, while standalone endoscopy centers in suburban areas offer the same procedures at significantly lower rates.
Insurance Market Competition in Illinois
The dominance of BCBS Illinois, UnitedHealthcare, and Aetna creates a moderately competitive insurance environment, though consolidation has reduced the number of smaller regional insurers. These major insurers negotiate different rates with the same providers, meaning your out-of-pocket costs can vary significantly based on your specific plan even for identical Upper Endoscopy procedures.
Physician Supply and Demand in Illinois
With over 3,600 active Upper Endoscopy providers, Illinois maintains adequate specialist supply relative to its population, particularly in the Chicago metropolitan area. This healthy provider density helps contain costs through competition, though wait times for routine procedures average 2-4 weeks while urgent cases can typically be accommodated within days.
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 Illinois
What is the average cost of a Upper Endoscopy visit in Illinois without insurance?
Does Illinois Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Illinois?
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 Illinois?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Illinois?
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 |