Cost of a Upper Endoscopy Visit
in New Jersey
Reviewed by Momentary Medical Group West PC
New Jersey's dense network of academic medical centers and specialty practices has created one of the highest concentrations of gastroenterologists per capita on the East Coast. Upper Endoscopy patients in the Garden State typically encounter negotiated insurance rates ranging from $74 to $758, with a median cost of $229 based on transparency data from over 6,500 active providers. New Jersey residents benefit from extensive provider choice across urban centers like Newark and Trenton as well as suburban corridors, making it easier to compare costs and find an in-network Upper Endoscopy specialist that fits both medical needs and budget.
Average
$354
Median
$229
Lowest
$74
Highest
$758
Providers
6,513
8% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in New Jersey?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $110 | $289 | $1,117 | 6,562 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $120 | $349 | $1,329 | 6,606 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $151 | $404 | $1,496 | 6,545 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $83 | $275 | $1,165 | 6,615 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $13 | $25 | $68 | 7,374 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $60 | $164 | $490 | 6,620 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $35 | $83 | $244 | 7,282 |
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 New Jersey
New Jersey's Upper Endoscopy costs run approximately 17% above national averages, driven by the state's proximity to high-cost New York metropolitan markets and dense population of specialist physicians. The Garden State's unique position as both a suburban health care hub and overflow market for NYC patients creates upward pressure on gastroenterology pricing.
Urban vs. Rural Provider Availability
Northern New Jersey counties like Bergen and Essex benefit from abundant Upper Endoscopy specialists due to proximity to Manhattan medical centers, while South Jersey relies more heavily on regional health systems like Cooper and AtlantiCare. This geographic disparity means patients in Cape May or Cumberland counties may face longer wait times but potentially lower costs. Urban areas typically offer more scheduling flexibility but higher facility fees.
Facility Type and Overhead Costs
Hospital-owned endoscopy centers dominate New Jersey's landscape through major health systems like RWJBarnabas, Hackensack Meridian, and Atlantic Health System. These hospital-affiliated facilities often charge separate facility fees ranging from $200-800 on top of physician fees. Independent gastroenterology practices, more common in suburban areas, typically offer more transparent all-inclusive pricing for Upper Endoscopy procedures.
Insurance Market Competition in New Jersey
Horizon Blue Cross Blue Shield maintains the largest market share in New Jersey, followed by Aetna and UnitedHealthcare, creating moderate competition that helps contain some cost increases. The state's proximity to New York and Pennsylvania allows some residents to access broader provider networks across state lines. Medicaid managed care plans through companies like AmeriHealth and UnitedHealthcare Community Plan have expanded access to Upper Endoscopy services in underserved areas.
Physician Supply and Demand in New Jersey
With over 6,500 Upper Endoscopy providers listed in transparency files, New Jersey maintains one of the highest gastroenterologist-to-population ratios in the nation. This abundant supply helps moderate wait times and provides patients with significant choice in selecting providers based on cost and convenience. However, the concentration of specialists in northern counties creates supply imbalances that can affect pricing and accessibility in more rural areas.
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 New Jersey
What is the average cost of a Upper Endoscopy visit in New Jersey without insurance?
Does New Jersey Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in New Jersey?
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 New Jersey?
How does telemedicine affect the cost of seeing a Upper Endoscopy in New Jersey?
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 |