Cost of a Upper Endoscopy Visit
in Tennessee
Reviewed by Momentary Medical Group West PC
Tennessee's healthcare market operates about 4% below national averages, creating cost advantages for patients needing specialized procedures across the state's mix of urban medical centers and rural facilities. Upper Endoscopy patients in Tennessee typically see costs ranging from $100.92 to $472.64, with a median procedure cost of $223.09 based on actual negotiated insurance rates. With 2,452 active providers performing Upper Endoscopy procedures statewide, Tennessee patients have substantial options when selecting their gastroenterologist or facility for this diagnostic procedure.
Average
$266
Median
$223
Lowest
$101
Highest
$473
Providers
2,452
31% below national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Tennessee?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $90 | $288 | $582 | 2,610 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $314 | $714 | 2,664 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $90 | $399 | $796 | 2,520 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $85 | $200 | $604 | 2,698 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $18 | $85 | 2,824 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $64 | $165 | $340 | 2,797 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $48 | $104 | $189 | 2,512 |
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 Tennessee
Tennessee's healthcare costs run approximately 4% below national averages, reflecting the state's lower overall cost of living and competitive provider market. The state's geography creates distinct cost zones, with Nashville and Memphis metropolitan areas supporting premium pricing while rural regions often struggle with provider access and lower reimbursement rates.
Urban vs. Rural Provider Availability
Tennessee's 95 counties include major metropolitan areas like Nashville-Davidson and Shelby County alongside sparsely populated rural regions in East and West Tennessee. Urban centers concentrate multiple health systems and independent gastroenterology practices, creating competitive pricing, while rural counties may have limited or no local Upper Endoscopy providers. Patients in rural areas often travel to regional medical centers, adding transportation costs but potentially accessing lower facility fees.
Facility Type and Overhead Costs
Hospital-based outpatient clinics typically charge higher facility fees due to regulatory compliance costs and comprehensive service offerings. Independent ambulatory surgery centers throughout Tennessee often provide Upper Endoscopy procedures at lower total costs due to specialized focus and streamlined operations. Major health systems like HCA Healthcare, Vanderbilt University Medical Center, and regional hospital networks each have different pricing structures and negotiated insurance rates.
Insurance Market Competition in Tennessee
BlueCross BlueShield of Tennessee holds significant market share statewide, joined by UnitedHealthcare and Cigna in creating moderate competition levels. The individual marketplace offers limited insurer options in many counties, reducing competitive pressure on negotiated rates. Employer-sponsored insurance markets show more variety, particularly in metropolitan areas where national insurers compete alongside regional players.
Physician Supply and Demand in Tennessee
Tennessee's 2,452 active Upper Endoscopy providers create adequate supply in urban markets but potential shortages in rural regions requiring patient travel. This provider distribution affects both pricing and wait times, with rural patients often facing longer scheduling delays but potentially lower procedure costs. The state's medical schools and residency programs help maintain gastroenterology workforce levels, though subspecialty distribution remains concentrated in major metropolitan areas.
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 Tennessee
What is the average cost of a Upper Endoscopy visit in Tennessee without insurance?
Does Tennessee Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Tennessee?
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 Tennessee?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Tennessee?
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 |