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
16% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Michigan?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $92 | $327 | $768 | 1,803 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $393 | $887 | 2,214 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $467 | $1,088 | 2,038 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $259 | $685 | 2,142 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $15 | $21 | $95 | 2,698 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $67 | $166 | $405 | 2,196 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $88 | $216 | 2,133 |
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 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 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.
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 Michigan
What is the average cost of a Upper Endoscopy visit in Michigan without insurance?
Does Michigan Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Michigan?
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 Michigan?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Michigan?
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 |
