Cost of a Upper Endoscopy Visit
in Montana
Reviewed by Momentary Medical Group West PC
Montana's vast rural geography means patients often travel significant distances for specialized Upper Endoscopy procedures, with the state's 40 active providers concentrated primarily in Billings, Missoula, and Great Falls. Patients typically pay between $90 and $581 for an Upper Endoscopy procedure, with a median cost of $231. Montana residents can browse all Upper Endoscopy providers across the state to find the most cost-effective options for their specific insurance plan and location.
Average
$301
Median
$231
Lowest
$90
Highest
$581
Providers
40
22% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Montana?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $80 | $80 | $538 | 319 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $80 | $545 | 315 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $80 | $3,638 | 307 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $80 | $523 | 327 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $80 | 367 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $80 | $80 | $269 | 318 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $51 | $68 | $991 | 354 |
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 Montana
Montana's Upper Endoscopy costs run approximately 24% below the national average, reflecting the state's lower overall healthcare costs and rural market dynamics. The state's sparse population density and limited specialist concentration create unique pricing pressures compared to more densely populated states.
Urban vs. Rural Provider Availability
Montana's Upper Endoscopy providers are heavily concentrated in Billings, Missoula, Great Falls, and Bozeman, requiring many rural residents to travel significant distances for procedures. This geographic constraint can increase overall costs when factoring in travel expenses, but rural facilities may offer more competitive procedure pricing to attract patients.
Facility Type and Overhead Costs
Hospital-based outpatient departments in Montana typically charge higher facility fees than independent ambulatory surgery centers, though the state has fewer ASC options than more populous states. Major health systems like Billings Clinic and Providence St. Patrick Hospital often have higher overhead costs reflected in their Upper Endoscopy pricing.
Insurance Market Competition in Montana
With Blue Cross Blue Shield of Montana, PacificSource, and UnitedHealthcare as the dominant insurers, Montana has moderate insurance market competition that affects negotiated rates for Upper Endoscopy procedures. The relatively small market size can limit insurers' negotiating power compared to larger states, potentially affecting procedure costs.
Physician Supply and Demand in Montana
Montana's 40 active Upper Endoscopy providers serve a geographically dispersed population, creating both access challenges and pricing variations across regions. This limited specialist supply relative to the state's geographic size can lead to longer wait times in rural areas but may also create competitive pricing in urban centers where multiple providers are available.
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 Montana
What is the average cost of a Upper Endoscopy visit in Montana without insurance?
Does Montana Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Montana?
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 Montana?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Montana?
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 |