Cost of a Upper Endoscopy Visit
in Indiana
Reviewed by Momentary Medical Group West PC
Indiana's healthcare market operates approximately 6% below national averages, making Upper Endoscopy procedures more affordable than many neighboring states. Patients typically pay between $90 and $691 for an Upper Endoscopy procedure, with a median cost of $304 based on negotiated insurance rates. Indiana maintains 296 active Upper Endoscopy providers across the state, offering patients multiple options for accessing care in both urban centers and rural communities.
Average
$361
Median
$304
Lowest
$90
Highest
$691
Providers
296
6% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Indiana?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $81 | $359 | $835 | 374 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $365 | $937 | 390 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $512 | $1,197 | 351 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $308 | $810 | 411 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $28 | $88 | 781 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $65 | $170 | $436 | 417 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $45 | $101 | $280 | 381 |
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 Indiana
Indiana's healthcare costs run approximately 6% below national averages, reflecting the state's lower cost of living and competitive provider market. The growing ambulatory surgery center market provides cost-effective alternatives to hospital-based procedures.
Urban vs. Rural Provider Availability
Indianapolis metro area contains the highest concentration of gastroenterologists, while rural counties in southern and northern Indiana face significant specialist shortages. Patients in rural areas often travel to Fort Wayne, Evansville, or Indianapolis for Upper Endoscopy procedures, adding transportation costs to their total expenses. Limited rural competition allows remaining providers to maintain higher pricing.
Facility Type and Overhead Costs
Hospital-owned outpatient centers typically charge 40-60% more than independent ambulatory surgery centers due to higher overhead costs and facility fees. Major health systems like Indiana University Health and Parkview Health operate multiple locations with standardized pricing structures. Independent gastroenterology practices often offer more competitive self-pay rates and flexible payment options.
Insurance Market Competition in Indiana
Anthem Blue Cross Blue Shield holds the largest market share, followed by UnitedHealthcare and MDwise, creating moderate competition that keeps negotiated rates reasonable. Rural areas have fewer insurer options, which can result in less favorable negotiated rates for providers and higher patient costs. The competitive Indianapolis market generally produces lower prices than less populated regions.
Physician Supply and Demand in Indiana
With 296 active Upper Endoscopy providers serving the state's 6.8 million residents, Indiana maintains adequate specialist availability in urban areas but faces shortages in rural regions. This supply-demand imbalance creates longer wait times and higher costs in underserved areas. The concentration of providers in major metropolitan areas helps control costs through competition.
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 Indiana
What is the average cost of a Upper Endoscopy visit in Indiana without insurance?
Does Indiana Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Indiana?
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 Indiana?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Indiana?
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 |