Cost of a Upper Endoscopy Visit
in New Mexico
Reviewed by Momentary Medical Group West PC
New Mexico's healthcare landscape serves a geographically diverse population across 121,000 square miles, with significant rural areas creating unique access challenges for specialized procedures. Upper Endoscopy patients in the state typically pay between $141 and $724 for their procedure, with a median out-of-pocket cost of $308 based on current negotiated rates. With over 1,190 active Upper Endoscopy providers throughout New Mexico, patients have multiple options for accessing this important diagnostic service across urban centers and rural communities.
Average
$391
Median
$308
Lowest
$141
Highest
$724
Providers
1,194
2% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in New Mexico?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $168 | $384 | $954 | 1,258 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $90 | $450 | $1,136 | 1,250 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $265 | $545 | $1,278 | 1,233 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $90 | $347 | $834 | 1,281 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $15 | $28 | $83 | 1,322 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $80 | $211 | $440 | 1,305 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $48 | $106 | $292 | 1,270 |
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 Mexico
New Mexico's Upper Endoscopy costs run approximately 3% below national averages, reflecting the state's lower overall cost of living and less competitive healthcare market. The state's vast rural geography and concentrated population centers create distinct pricing patterns between urban areas like Albuquerque and Santa Fe versus smaller communities.
Urban vs. Rural Provider Availability
Albuquerque and Santa Fe concentrate most of New Mexico's gastroenterology specialists, while rural counties often require patients to travel significant distances for Upper Endoscopy services. This geographic disparity can create cost differences, with rural facilities sometimes charging premium rates due to limited competition, while urban centers may offer more competitive pricing due to higher provider density.
Facility Type and Overhead Costs
Hospital-based outpatient endoscopy departments typically charge higher facility fees than independent ambulatory surgery centers in New Mexico's major cities. Presbyterian Healthcare Services and University of New Mexico Health Sciences Center represent major health systems that often carry higher overhead costs, while smaller independent practices may offer more competitive procedure pricing.
Insurance Market Competition in New Mexico
The state's insurance market lacks robust competition with BCBS NM holding significant market share alongside UHC and Molina, potentially limiting negotiated rate variations across providers. This concentrated market can result in more standardized reimbursement rates but fewer opportunities for dramatic cost savings through insurer competition compared to more competitive state markets.
Physician Supply and Demand in New Mexico
With over 1,190 providers performing Upper Endoscopy procedures statewide, New Mexico maintains adequate specialist availability relative to its population of 2.1 million residents. However, geographic distribution remains uneven, with rural areas experiencing longer wait times and potentially higher costs due to limited local specialist availability requiring patients to seek care in urban centers.
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 Mexico
What is the average cost of a Upper Endoscopy visit in New Mexico without insurance?
Does New Mexico Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in New Mexico?
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 Mexico?
How does telemedicine affect the cost of seeing a Upper Endoscopy in New Mexico?
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 |