Cost of a Upper Endoscopy Visit
in Vermont
Reviewed by Momentary Medical Group West PC
Vermont's rural geography creates unique challenges for specialist access, with many patients traveling significant distances for gastrointestinal procedures like Upper Endoscopy. Patients typically pay between $210.96 and $672.59 for an Upper Endoscopy procedure, with a median out-of-pocket cost of $361.95. Vermont has 325 active Upper Endoscopy providers across the state, offering patients options from Burlington's medical centers to smaller regional facilities.
Average
$415
Median
$362
Lowest
$211
Highest
$673
Providers
325
8% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in Vermont?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $106 | $347 | $801 | 334 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $317 | $537 | $1,042 | 337 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $333 | $553 | $1,096 | 337 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $273 | $476 | $907 | 339 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $11 | $18 | $73 | 352 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $61 | $171 | $471 | 348 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $42 | $124 | $341 | 337 |
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 Vermont
Vermont's Upper Endoscopy costs run approximately 20% above the national average, reflecting the state's rural geography and limited provider competition. The concentration of specialists in the Burlington area creates cost disparities between urban and rural regions throughout the Green Mountain State.
Urban vs. Rural Provider Availability
Most of Vermont's Upper Endoscopy specialists practice in the Burlington-South Burlington area or along the I-89 corridor, leaving rural counties with limited local access. Patients in the Northeast Kingdom or southern Vermont often face longer travel times, which some facilities offset by offering block scheduling or extended procedure days to accommodate distant patients.
Facility Type and Overhead Costs
Vermont's healthcare landscape includes large systems like UVM Medical Center alongside smaller independent gastroenterology practices, creating significant cost variation. Hospital-based outpatient departments typically charge facility fees that can add $200-500 to the total procedure cost compared to freestanding endoscopy centers.
Insurance Market Competition in Vermont
The dominance of BCBS VT and MVP Health Care in Vermont's insurance market creates less competitive pressure on negotiated rates compared to states with more insurer options. This concentrated market can result in higher baseline costs, though the state's regulatory oversight helps prevent excessive rate increases for Upper Endoscopy procedures.
Physician Supply and Demand in Vermont
With 325 active Upper Endoscopy providers serving Vermont's population of roughly 650,000, the state maintains adequate specialist availability in urban areas but faces shortages in rural regions. This geographic imbalance can drive up costs in underserved areas while creating more competitive pricing in Burlington and surrounding communities.
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 Vermont
What is the average cost of a Upper Endoscopy visit in Vermont without insurance?
Does Vermont Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in Vermont?
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 Vermont?
How does telemedicine affect the cost of seeing a Upper Endoscopy in Vermont?
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 |
