Cost of a Upper Endoscopy Visit
in Ohio
Reviewed by Momentary Medical Group West PC
Ohio's healthcare landscape features over 4,400 Upper Endoscopy providers serving the state's 11.8 million residents, with costs running approximately 35% below the national average. Patients typically pay between $76.66 and $474.02 for an Upper Endoscopy procedure, with a median negotiated rate of $195.28 across Ohio's diverse healthcare market. The state's robust provider network spans from Cleveland Clinic and Ohio State University Wexner Medical Center to smaller community hospitals and ambulatory surgery centers throughout Ohio's 88 counties.
Average
$249
Median
$195
Lowest
$77
Highest
$474
Providers
4,445
35% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Ohio?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $326 | $565 | 4,648 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $319 | $709 | 4,738 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $191 | $407 | $751 | 4,236 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $85 | $220 | $621 | 4,786 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $11 | $19 | $85 | 6,459 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $52 | $132 | $351 | 5,273 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $32 | $87 | $211 | 4,369 |
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 Ohio
Ohio's Upper Endoscopy costs run approximately 35% below national averages, reflecting the state's competitive healthcare market and lower overall cost of living compared to coastal states. The state's mix of major academic medical centers, community hospitals, and growing ambulatory surgery center network creates pricing variation across different facility types and regions.
Urban vs. Rural Provider Availability
Ohio's major metropolitan areas like Columbus, Cleveland, and Cincinnati offer abundant Upper Endoscopy options with competitive pricing, while rural counties in southeastern and northwestern Ohio may have limited gastroenterology access. Patients in rural areas often travel to regional centers like Toledo, Dayton, or Akron for specialized endoscopic procedures. This geographic disparity can affect both costs and wait times, with rural patients sometimes paying higher travel-related expenses.
Facility Type and Overhead Costs
Hospital-based endoscopy suites at systems like Cleveland Clinic, OhioHealth, and Kettering Health typically charge higher facility fees than independent ambulatory surgery centers throughout Ohio. The state's growing ASC market, particularly around major metros, offers more cost-effective alternatives for routine Upper Endoscopy procedures. Academic medical centers like Ohio State Wexner Medical Center may charge premium rates but offer specialized expertise for complex cases.
Insurance Market Competition in Ohio
Medical Mutual of Ohio, Anthem, and UnitedHealthcare dominate the state's insurance market, creating moderate competition that helps control Upper Endoscopy procedure costs. Regional players like Humana and Aetna provide additional options in certain markets, while the state's Medicaid expansion has increased patient volume and negotiating leverage for providers. This competitive environment generally keeps negotiated rates below national benchmarks.
Physician Supply and Demand in Ohio
With over 4,400 Upper Endoscopy providers statewide, Ohio maintains adequate gastroenterology capacity relative to its population, helping moderate pricing pressure. This robust provider supply is concentrated in urban areas, with Cleveland, Columbus, and Cincinnati accounting for a significant portion of the state's endoscopic capacity. The adequate physician supply typically translates to reasonable wait times and competitive pricing, though rural areas may still experience access challenges.
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 Ohio
What is the average cost of a Upper Endoscopy visit in Ohio without insurance?
Does Ohio Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Ohio?
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 Ohio?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Ohio?
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 |