Cost of a Upper Endoscopy Visit
in North Carolina
Reviewed by Momentary Medical Group West PC
North Carolina's healthcare landscape features over 2,200 Upper Endoscopy providers across the state, creating competitive pricing that runs approximately 2% below national averages. Patients seeking Upper Endoscopy procedures typically pay between $119.74 and $852.8, with a median cost of $298.1 based on negotiated insurance rates. With North Carolina's growing ambulatory surgery center market and strong provider network spanning from the Research Triangle to rural mountain counties, patients have numerous options for accessing quality endoscopic care throughout the state.
Average
$424
Median
$298
Lowest
$120
Highest
$853
Providers
2,213
11% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in North Carolina?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $90 | $378 | $1,065 | 2,531 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $444 | $1,268 | 2,531 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $543 | $1,433 | 2,407 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $318 | $1,088 | 2,729 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $26 | $85 | 2,727 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $68 | $194 | $501 | 2,737 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $44 | $107 | $272 | 2,508 |
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 North Carolina
North Carolina's Upper Endoscopy costs run approximately 2% below national averages, reflecting the state's competitive healthcare market and growing ambulatory surgery center network. The state's diverse geography creates significant cost variations between urban medical centers and rural community hospitals.
Urban vs. Rural Provider Availability
The Research Triangle, Charlotte, and Greensboro-Winston-Salem areas concentrate most Upper Endoscopy specialists, creating competitive pricing in these metropolitan regions. Rural counties in the mountains and eastern plains have limited specialist access, often requiring patients to travel to urban centers and potentially face higher costs due to limited competition. Telehealth consultations are increasingly bridging this gap for follow-up care.
Facility Type and Overhead Costs
North Carolina's growing ambulatory surgery center market offers cost-effective alternatives to hospital-based endoscopy suites, with ASCs typically charging 20-40% less than hospital outpatient departments. Major health systems like Atrium Health, UNC Health, and Cone Health operate extensive networks but may carry higher facility fees due to academic affiliations and comprehensive service offerings.
Insurance Market Competition in North Carolina
The state's insurance market concentration among BCBS NC, UHC, and Aetna creates limited negotiating leverage for providers, helping keep costs relatively stable. Rural markets often have even fewer insurer options, reducing competitive pressure on rates. The lack of Medicaid expansion also affects provider payment mix and cost structures across the state.
Physician Supply and Demand in North Carolina
With over 2,200 Upper Endoscopy providers statewide, North Carolina maintains adequate specialist availability in urban areas while facing shortages in rural regions. This supply distribution creates cost disparities, with urban competition helping moderate prices while rural scarcity may drive higher rates. Wait times for routine procedures are generally reasonable in metropolitan areas but may extend several weeks in underserved counties.
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 North Carolina
What is the average cost of a Upper Endoscopy visit in North Carolina without insurance?
Does North Carolina Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in North Carolina?
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 North Carolina?
How does telemedicine affect the cost of seeing a Upper Endoscopy in North Carolina?
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 |