Cost of a Upper Endoscopy Visit
in West Virginia
Reviewed by Momentary Medical Group West PC
West Virginia's mountainous geography and rural healthcare challenges create unique cost patterns for gastroenterology services across the state's 55 counties. Upper Endoscopy procedures in West Virginia typically range from $93 to $889, with a median cost of $274 based on negotiated insurance rates from 98 active providers. The state's network of gastroenterology specialists serves both urban centers like Charleston and remote Appalachian communities, creating significant price variation depending on facility type and location.
Average
$419
Median
$274
Lowest
$93
Highest
$889
Providers
98
9% above national average
Compare Similar Procedures
How does upper endoscopy (egd) compare to related procedures in West Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Colonoscopy Diagnostic colonoscopy | 45378 | $85 | $357 | $1,395 | 106 |
| Colonoscopy with Biopsy Colonoscopy with biopsy | 45380 | $85 | $308 | $1,329 | 163 |
| Colonoscopy with Polyp Removal Colonoscopy with polyp removal by snare | 45385 | $98 | $410 | $1,538 | 153 |
| Upper Endoscopy with Biopsy Upper GI endoscopy with biopsy | 43239 | $80 | $298 | $1,647 | 122 |
| ECG / EKG 12-lead electrocardiogram with interpretation | 93000 | $14 | $14 | $91 | 304 |
| Echocardiogram Transthoracic echocardiogram with Doppler | 93306 | $66 | $155 | $1,167 | 201 |
| OB Ultrasound Obstetric ultrasound, complete | 76805 | $50 | $68 | $215 | 208 |
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 West Virginia
West Virginia's Upper Endoscopy costs run approximately 2% below national averages, reflecting the state's lower overall healthcare spending and rural market dynamics. The state's mountainous terrain and scattered population create unique access challenges that influence both provider availability and procedure pricing across different regions.
Urban vs. Rural Provider Availability
Charleston, Morgantown, and Huntington concentrate most of West Virginia's gastroenterology specialists, creating cost advantages through higher procedure volumes and competitive pricing. Rural counties often rely on visiting specialists or require patients to travel significant distances for Upper Endoscopy procedures. This geographic disparity leads to higher effective costs for rural patients when factoring in travel expenses and time off work.
Facility Type and Overhead Costs
Hospital-based endoscopy centers affiliated with major health systems like Charleston Area Medical Center, WVU Medicine, and Cabell Huntington Hospital typically charge higher facility fees due to overhead costs and comprehensive support services. Independent gastroenterology practices often offer more competitive pricing but may have limited availability for complex cases. Ambulatory surgery centers provide a middle-ground option with lower costs than hospitals but more resources than office-based procedures.
Insurance Market Competition in West Virginia
The state's insurance market features moderate competition among Highmark West Virginia, UnitedHealthcare, and Aetna, with regional variations in negotiated rates for gastroenterology services. Highmark West Virginia maintains the largest provider network, potentially offering more in-network options but not necessarily the lowest costs. Rural areas may have limited insurer participation, reducing competitive pressure on procedure pricing.
Physician Supply and Demand in West Virginia
With 98 active providers offering Upper Endoscopy services, West Virginia maintains adequate specialist coverage relative to its population, though geographic distribution favors urban areas. The state's physician shortage in rural counties creates longer wait times and potentially higher costs for patients unable to travel to metropolitan areas. Medical school programs at West Virginia University help train future gastroenterologists, though many graduates leave the state for higher-paying markets.
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 West Virginia
What is the average cost of a Upper Endoscopy visit in West Virginia without insurance?
Does West Virginia Medicaid cover Upper Endoscopy visits?
How do I find an affordable Upper Endoscopy near me in West Virginia?
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 West Virginia?
How does telemedicine affect the cost of seeing a Upper Endoscopy in West Virginia?
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 |