Cost of a Upper Endoscopy Visit
in South Dakota
Reviewed by Momentary Medical Group West PC
South Dakota's largely rural healthcare landscape creates unique access patterns for specialty care, with many residents traveling significant distances for procedures like Upper Endoscopy. Patients typically pay between $103 and $691 for an Upper Endoscopy procedure, with a median out-of-pocket cost of $275. South Dakota has 52 active Upper Endoscopy providers serving the state's 900,000 residents, allowing patients to browse options across different regions and health systems.
Average
$356
Median
$275
Lowest
$103
Highest
$691
Providers
52
7% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in South Dakota?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $345 | $2,255 | 79 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $80 | $389 | $1,035 | 66 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $80 | $491 | $1,090 | 61 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $85 | $332 | $2,396 | 77 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $26 | $26 | $26 | 328 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $67 | $169 | $460 | 73 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $68 | $68 | $117 | 309 |
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 South Dakota
Upper Endoscopy costs in South Dakota run approximately 9% below national averages, reflecting the state's lower healthcare overhead and physician compensation levels. The state's sparse population density creates unique cost pressures as specialty practices must serve large geographic areas with relatively few patients.
Urban vs. Rural Provider Availability
Most of South Dakota's gastroenterologists practice in Sioux Falls, Rapid City, and Aberdeen, requiring rural patients to travel 100+ miles for Upper Endoscopy procedures. This geographic concentration allows urban practices to maintain higher volumes and potentially lower per-procedure costs. Rural hospitals occasionally host visiting gastroenterologists but typically refer complex cases to regional medical centers.
Facility Type and Overhead Costs
Sanford Health and Avera Health Systems operate most hospital-based endoscopy centers in South Dakota, which typically charge facility fees on top of physician fees. Independent gastroenterology practices and ambulatory surgery centers often provide more transparent pricing without separate facility charges. Monument Health dominates the western region around Rapid City with similar hospital-based pricing structures.
Insurance Market Competition in South Dakota
Wellmark Blue Cross Blue Shield holds the largest market share in South Dakota, followed by Sanford Health Plan and UnitedHealthcare, creating moderate insurer competition. This relatively concentrated market can limit negotiating power for smaller provider groups compared to states with more insurance options. Regional insurers like Sanford often have preferred partnerships with their own health system facilities.
Physician Supply and Demand in South Dakota
With 52 active Upper Endoscopy providers serving 900,000 residents, South Dakota maintains adequate gastroenterology coverage compared to many rural states. However, most specialists concentrate in the eastern part of the state, creating longer wait times and higher costs in western regions. The adequate supply in urban areas helps keep pricing competitive among established practices.
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 South Dakota
What is the average cost of a Upper Endoscopy visit in South Dakota without insurance?
Does South Dakota Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in South Dakota?
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 South Dakota?
How does telemedicine affect the cost of seeing a Upper Endoscopy in South Dakota?
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 |