Cost of a Upper Endoscopy Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's compact healthcare market features 58 active Upper Endoscopy providers across the state's 39 cities and towns, creating relatively strong access despite the Ocean State's small geographic footprint. Based on negotiated insurance rates, Rhode Island patients typically pay between $109 and $718 for an Upper Endoscopy procedure, with a median out-of-pocket cost of $391. With many experienced gastroenterologists practicing throughout Providence, Newport, and Warwick, patients can browse all Upper Endoscopy providers in Rhode Island to find quality care that fits their budget.
Average
$406
Median
$391
Lowest
$109
Highest
$718
Providers
58
6% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $91 | $423 | $1,830 | 63 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $535 | $2,117 | 77 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $673 | $2,338 | 75 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $418 | $1,647 | 83 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $28 | $90 | 108 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $207 | $895 | 90 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $115 | $328 | 80 |
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 Rhode Island
Rhode Island's Upper Endoscopy costs run approximately 13% above the national average, reflecting the Ocean State's higher healthcare overhead and concentrated provider market. The state's small geographic area creates unique cost dynamics, with most specialty care concentrated in the Providence metropolitan area while rural communities face limited local options.
Urban vs. Rural Provider Availability
Providence and surrounding urban areas house the majority of Rhode Island's 58 Upper Endoscopy providers, creating competitive pricing in the metro region while rural areas like Washington County may require patients to travel for care. This geographic concentration can drive up costs in urban centers due to higher real estate and operational expenses, while rural patients often face longer wait times and travel costs.
Facility Type and Overhead Costs
Hospital-based endoscopy centers affiliated with major Rhode Island health systems like Lifespan and Care New England typically charge 40-60% more than independent gastroenterology practices due to facility fees and administrative overhead. Ambulatory surgery centers offer a middle-ground option, providing hospital-quality equipment and safety protocols while maintaining lower operational costs than full-service hospitals.
Insurance Market Competition in Rhode Island
The limited number of major insurers operating in Rhode Island - primarily BCBS RI, UnitedHealthcare, and Tufts - creates less competitive pressure on negotiated rates compared to states with more diverse insurance markets. This concentrated market structure can result in higher reimbursement rates for providers, which ultimately translates to increased costs for patients through higher premiums and out-of-pocket expenses.
Physician Supply and Demand in Rhode Island
With 58 active Upper Endoscopy providers serving Rhode Island's population of approximately 1.1 million residents, the state maintains adequate gastroenterologist availability relative to national benchmarks. This reasonable supply-to-demand ratio helps prevent the extreme pricing premiums seen in physician-shortage areas, though subspecialty services may still command higher fees due to limited provider options for complex cases.
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 Rhode Island
What is the average cost of a Upper Endoscopy visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Rhode Island?
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 Rhode Island?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Rhode Island?
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 |