Logo
Michigan

Cost of a Upper Endoscopy Visit
in Michigan

Reviewed by Momentary Medical Group West PC

Michigan's healthcare market, with over 1,670 active Upper Endoscopy providers across the state, offers patients significant cost savings compared to national averages. Patients typically pay between $121 and $572 for an Upper Endoscopy procedure, with a median negotiated rate of $274 based on actual insurance company data. The state's expanded Medicaid program and competitive insurer landscape help keep costs approximately 10% below national benchmarks, giving patients access to quality gastroenterology care at more affordable rates throughout Michigan.

Average

$322

Median

$274

Lowest

$121

Highest

$572

Providers

1,673

National avg: $383Michigan: $322

16% below national average

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
Colonoscopy

Diagnostic colonoscopy

45378$92$327$7681,803
Colonoscopy with Biopsy

Colonoscopy with biopsy

45380$80$393$8872,214
Colonoscopy with Polyp Removal

Colonoscopy with polyp removal by snare

45385$80$467$1,0882,038
Upper Endoscopy with Biopsy

Upper GI endoscopy with biopsy

43239$80$259$6852,142
ECG / EKG

12-lead electrocardiogram with interpretation

93000$15$21$952,698
Echocardiogram

Transthoracic echocardiogram with Doppler

93306$67$166$4052,196
OB Ultrasound

Obstetric ultrasound, complete

76805$42$88$2162,133

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 Michigan

Michigan's healthcare costs run approximately 10% below national averages, driven by moderate competition among insurers and a robust network of both academic medical centers and community hospitals. The state's mix of urban centers like Detroit-Ann Arbor and vast rural regions creates distinct cost patterns across different markets.

Urban vs. Rural Provider Availability

Metro Detroit, Grand Rapids, and Ann Arbor concentrate most of Michigan's gastroenterology specialists, offering competitive pricing but potentially higher facility fees at major health systems. Rural counties in northern Michigan and the Upper Peninsula have fewer providers, sometimes requiring patients to travel significant distances but often finding lower overhead costs at community hospitals.

Facility Type and Overhead Costs

Hospital-owned outpatient centers affiliated with systems like Henry Ford, Beaumont, or University of Michigan typically charge higher facility fees than independent ambulatory surgery centers. Freestanding endoscopy centers throughout Michigan often offer the most cost-effective option for routine Upper Endoscopy procedures.

Insurance Market Competition in Michigan

The presence of multiple major insurers including BCBS Michigan, UHC, and Aetna creates moderate competition that helps control negotiated rates for Upper Endoscopy procedures. Regional insurers and Medicaid managed care plans add additional competitive pressure, particularly in southeastern Michigan's dense provider markets.

Physician Supply and Demand in Michigan

With over 1,670 active Upper Endoscopy providers, Michigan maintains adequate specialist availability relative to its population, helping prevent the supply shortages that drive up costs in other states. This robust provider network supports reasonable wait times and competitive pricing, particularly in metropolitan areas where multiple gastroenterology practices compete for patients.

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 Michigan

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

Uninsured patients in Michigan can expect to pay between $121 and $572 for an Upper Endoscopy, with a median cost of $274 based on actual negotiated rates. Many providers offer self-pay discounts of 20-40% for cash payments, and some facilities provide payment plans to help manage costs.

Does Michigan Medicaid cover Upper Endoscopy visits?

Yes, Michigan's expanded Medicaid program covers medically necessary Upper Endoscopy procedures for eligible adults. Coverage includes both diagnostic procedures for symptoms and screening endoscopies for high-risk patients, typically with minimal or no out-of-pocket costs.

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

Compare costs between hospital-owned outpatient centers and independent ambulatory surgery centers, as the latter often offer lower facility fees. Ask about self-pay discounts, consider community health centers, and verify that both the physician and facility are in your insurance network to minimize costs.

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

Initial gastroenterology consultations typically cost more than the Upper Endoscopy procedure itself, often ranging from $200-400, while the actual endoscopy procedure costs between $121-572 in Michigan. Follow-up visits after the procedure are usually brief and cost significantly less than the initial consultation.

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

Yes, Upper Endoscopy procedures qualify as eligible medical expenses for both HSA and FSA accounts. You can use these pre-tax dollars to pay for the procedure, related medications, and any necessary follow-up care, helping reduce your overall out-of-pocket costs.

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

While the Upper Endoscopy procedure itself requires an in-person visit, initial consultations and follow-up appointments can often be conducted via telehealth at lower costs. Many Michigan gastroenterologists offer virtual consultations for $100-200, which can help determine if an endoscopy is necessary before scheduling the procedure.

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