Price AtlasInteractive atlas · All states · techysurgeon.comUpper endoscopy (EGD), diagnostic: what insurers pay
Scope of the esophagus, stomach and duodenum without biopsy. Commercial negotiated rates by hospital and market, next to Medicare for the same code.
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CPT 43235: Upper Endoscopy (Egd), Diagnostic
1504 hospitals in 81 markets. National Medicare rate $927, surgery center $498.
| Market | Hospitals | 25th pct | Median | 75th pct | Low–high |
|---|---|---|---|---|---|
| Alabama (statewide) | 21 | $979 | $1,502 | $2,076 | $456–$3,146 |
| Alaska (statewide) | 4 | — | — | — | $1,348–$4,590 |
| Arizona (statewide) | 13 | $1,891 | $2,154 | $2,829 | $603–$3,945 |
| Arkansas (statewide) | 15 | $844 | $859 | $1,296 | $568–$1,472 |
| Atlanta GA | 10 | $3,320 | $3,320 | $3,453 | $2,730–$3,453 |
| Austin TX | 13 | $909 | $1,838 | $3,230 | $862–$3,230 |
| Boston MA | 16 | $1,160 | $1,448 | $1,527 | $762–$2,001 |
| California (statewide) | 74 | $1,408 | $2,766 | $3,547 | $784–$7,455 |
| Charlotte NC | 6 | $1,115 | $1,115 | $1,115 | $1,099–$4,354 |
| Chicago IL | 11 | $2,704 | $3,306 | $3,622 | $1,238–$4,955 |
| Cleveland OH | 11 | $1,994 | $2,276 | $2,328 | $1,578–$2,482 |
| Colorado (statewide) | 18 | $1,200 | $1,980 | $2,903 | $688–$4,600 |
| Columbus OH | 1 | — | — | — | $3,262–$3,262 |
| Connecticut (statewide) | 3 | — | — | — | $1,228–$3,779 |
| Dallas-Fort Worth TX | 13 | $2,224 | $2,613 | $2,808 | $1,934–$4,164 |
| Delaware (statewide) | 1 | — | — | — | $1,928–$1,928 |
| Denver CO | 15 | $1,795 | $3,542 | $4,007 | $1,083–$4,600 |
| Detroit MI | 17 | $852 | $1,131 | $1,135 | $541–$5,085 |
| Florida (statewide) | 71 | $1,647 | $2,236 | $3,022 | $506–$7,541 |
| Georgia (statewide) | 45 | $2,153 | $2,792 | $3,348 | $828–$4,626 |
| Hawaii (statewide) | 7 | $1,352 | $1,988 | $2,490 | $1,167–$2,833 |
| Houston TX | 19 | $1,731 | $2,136 | $2,465 | $1,353–$2,673 |
| Idaho (statewide) | 19 | $882 | $1,251 | $1,864 | $583–$2,747 |
| Illinois (statewide) | 38 | $1,368 | $1,790 | $2,318 | $879–$4,210 |
| Indiana (statewide) | 41 | $1,570 | $2,202 | $3,309 | $808–$5,496 |
| Indianapolis IN | 2 | — | — | — | $1,454–$3,773 |
| Iowa (statewide) | 34 | $819 | $1,386 | $1,735 | $485–$2,752 |
| Kansas (statewide) | 47 | $1,033 | $1,172 | $1,572 | $463–$4,343 |
| Kentucky (statewide) | 23 | $1,270 | $1,551 | $2,427 | $766–$5,279 |
| Las Vegas NV | 2 | — | — | — | $1,656–$2,060 |
| Los Angeles CA | 17 | $2,572 | $2,895 | $3,398 | $1,480–$6,910 |
| Louisiana (statewide) | 25 | $1,012 | $1,164 | $1,464 | $716–$3,139 |
| Maine (statewide) | 17 | $3,700 | $3,842 | $4,313 | $897–$5,608 |
| Maryland (statewide) | 1 | — | — | — | $1,962–$1,962 |
| Massachusetts (statewide) | 11 | $1,098 | $1,387 | $1,792 | $871–$1,946 |
| Miami-Fort Lauderdale FL | 2 | — | — | — | $1,456–$1,883 |
| Michigan (statewide) | 34 | $808 | $905 | $1,309 | $498–$1,803 |
| Minneapolis-St. Paul MN | 10 | $1,727 | $2,042 | $2,220 | $1,491–$2,264 |
| Minnesota (statewide) | 29 | $1,642 | $2,270 | $2,780 | $851–$3,732 |
| Mississippi (statewide) | 25 | $1,108 | $1,503 | $1,614 | $630–$2,684 |
| Missouri (statewide) | 36 | $1,218 | $1,840 | $2,794 | $471–$6,278 |
| Montana (statewide) | 7 | $1,928 | $2,052 | $2,644 | $1,172–$3,607 |
| Nashville TN | 8 | $1,403 | $2,022 | $2,172 | $1,257–$2,212 |
| Nebraska (statewide) | 25 | $1,656 | $2,012 | $2,599 | $531–$6,353 |
| Nevada (statewide) | 7 | $1,687 | $1,718 | $1,850 | $756–$2,364 |
| New Hampshire (statewide) | 6 | $2,151 | $2,694 | $3,242 | $1,983–$4,062 |
| New Jersey (statewide) | 26 | $1,880 | $2,996 | $4,187 | $1,024–$7,460 |
| New Mexico (statewide) | 11 | $1,395 | $1,787 | $3,324 | $816–$4,752 |
| New York (statewide) | 37 | $1,475 | $2,024 | $2,830 | $827–$6,095 |
| New York City | 8 | $1,475 | $1,475 | $3,522 | $1,266–$6,964 |
| North Carolina (statewide) | 11 | $1,584 | $2,246 | $2,674 | $831–$4,154 |
| North Dakota (statewide) | 9 | $1,601 | $2,000 | $2,270 | $645–$3,178 |
| Ohio (statewide) | 45 | $2,098 | $2,286 | $3,098 | $478–$4,300 |
| Oklahoma (statewide) | 20 | $1,462 | $1,839 | $2,078 | $927–$6,153 |
| Oregon (statewide) | 16 | $2,002 | $2,660 | $3,035 | $647–$4,636 |
| Pennsylvania (statewide) | 49 | $1,386 | $2,158 | $2,887 | $920–$4,011 |
| Philadelphia PA | 11 | $2,288 | $2,388 | $3,071 | $2,196–$6,185 |
| Phoenix AZ | 8 | $2,214 | $2,332 | $2,421 | $2,130–$2,421 |
| Pittsburgh PA | 12 | $1,307 | $1,481 | $1,919 | $1,176–$2,360 |
| Portland OR | 9 | $3,896 | $3,899 | $3,899 | $3,896–$4,114 |
| Rhode Island (statewide) | 6 | $1,262 | $1,927 | $2,827 | $908–$2,991 |
| Richmond VA | 3 | — | — | — | $3,534–$3,591 |
| Rio Grande Valley TX | 6 | $1,190 | $1,758 | $2,818 | $1,179–$2,993 |
| Salt Lake City UT | 9 | $1,589 | $1,589 | $1,589 | $1,589–$1,589 |
| San Antonio TX | 3 | — | — | — | $1,497–$2,613 |
| San Diego CA | 7 | $1,983 | $1,983 | $1,996 | $1,668–$2,151 |
| San Francisco Bay Area CA | 5 | $1,972 | $3,227 | $3,859 | $1,601–$4,959 |
| Seattle-Tacoma WA | 16 | $2,798 | $3,026 | $3,049 | $2,396–$3,303 |
| South Carolina (statewide) | 26 | $1,815 | $2,680 | $3,722 | $683–$5,187 |
| South Dakota (statewide) | 7 | $1,698 | $2,530 | $2,702 | $756–$4,742 |
| St. Louis MO | 10 | $1,711 | $1,920 | $1,920 | $1,576–$3,456 |
| Tampa FL | 6 | $978 | $978 | $1,466 | $978–$4,633 |
| Tennessee (statewide) | 40 | $1,239 | $1,350 | $1,731 | $761–$2,272 |
| Texas (statewide) | 85 | $1,353 | $2,224 | $2,664 | $737–$5,496 |
| Utah (statewide) | 16 | $1,589 | $1,589 | $1,589 | $510–$3,145 |
| Vermont (statewide) | 4 | — | — | — | $490–$3,563 |
| Virginia (statewide) | 28 | $2,445 | $3,360 | $3,739 | $1,107–$4,675 |
| Washington (statewide) | 16 | $1,674 | $2,327 | $2,715 | $612–$5,018 |
| Washington DC | 11 | $2,348 | $2,485 | $2,585 | $2,171–$2,716 |
| West Virginia (statewide) | 11 | $1,292 | $1,515 | $2,954 | $813–$6,038 |
| Wisconsin (statewide) | 47 | $2,225 | $3,006 | $3,445 | $664–$5,220 |
Lowest and highest 12 hospital medians
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Usa Health Children'S & Women'S Hospital | Alabama (statewide) | $456 | 0.6× | 2 | 2026-04-30 |
| Nemaha Valley Community Hospital | Kansas (statewide) | $463 | 0.6× | 1 | 2026-09-16 |
| Amberwell Hiawatha | Kansas (statewide) | $463 | 0.6× | 1 | 2026-08-18 |
| Clay County Medical Center | Kansas (statewide) | $463 | 0.6× | 1 | 2026-07-22 |
| Mercy Hospital Aurora | Missouri (statewide) | $471 | 0.5× | 4 | 2026-06-10 |
| Paulding County Hospital | Ohio (statewide) | $478 | 0.6× | 3 | 2025-11-01 |
| Orange City Area Health System | Iowa (statewide) | $485 | 0.6× | 1 | 2026-09-23 |
| Northeastern Vermont Regional Hospital | Vermont (statewide) | $490 | 0.5× | 1 | 2026-08-27 |
| Hancock County Health System | Iowa (statewide) | $493 | 0.6× | 1 | 2026-06-30 |
| Holland Hospital | Michigan (statewide) | $498 | 0.6× | 4 | 2026-09-21 |
| Helen Newberry Joy Hospital | Michigan (statewide) | $498 | 0.6× | 1 | 2026-09-02 |
| Calhoun-Liberty Hospital | Florida (statewide) | $506 | 0.5× | 1 | 2026-08-12 |
| Jefferson Stratford Hospital | Philadelphia PA | $6,185 | 6.1× | 3 | 2026-09-15 |
| St Louis Childrens Hospital | Missouri (statewide) | $6,278 | 6.9× | 1 | 2025-12-15 |
| Chi Health St Francis | Nebraska (statewide) | $6,353 | 6.7× | 6 | 2026-02-28 |
| Watsonville Community Hospital | California (statewide) | $6,374 | 5.1× | 14 | 2026-09-15 |
| Rady Children'S Hospital - San Diego | California (statewide) | $6,394 | 5.5× | 4 | 2026-04-01 |
| Providence St Joseph Hospital | California (statewide) | $6,727 | 5.8× | 4 | 2026-04-01 |
| Hoag Memorial Hospital Presbyterian | Los Angeles CA | $6,910 | 5.9× | 4 | 2026-04-01 |
| NYU Langone Hospitals (Orthopedic Hospital + Tisch files) | New York City | $6,964 | 6.2× | 9 | 2026-01-01 |
| Los Robles Hospital & Medical Center | California (statewide) | $7,068 | 6.1× | 4 | 2026-09-01 |
| Providence Queen Of The Valley Medical Center | California (statewide) | $7,455 | 6.4× | 5 | 2026-04-01 |
| Hackensack University Medical Center | New Jersey (statewide) | $7,460 | 6.9× | 4 | 2025-12-31 |
| Holy Cross Hospital | Florida (statewide) | $7,541 | 8.0× | 24 | 2026-03-31 |
Every hospital is on its state's page (linked in the market table) and in the interactive explorer.
Questions
How much do commercial insurers pay hospitals for upper endoscopy (egd), diagnostic?
Across 1504 hospitals in 81 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 43235, hospital outpatient is $2,036, 2.2× the same hospital's local Medicare base rate. The middle half of hospitals runs $1,308 to $2,923. Figures are each hospital's median across insurers, from its federal price-transparency file.
What does Medicare pay for upper endoscopy (egd), diagnostic?
Medicare's national hospital outpatient rate for CPT 43235 is $927 and its surgery-center rate is $498, before local wage adjustment.
Which hospitals post the lowest and highest commercial rates for upper endoscopy (egd), diagnostic?
Lowest medians: Usa Health Children'S & Women'S Hospital ($456), Nemaha Valley Community Hospital ($463), Amberwell Hiawatha ($463). Highest: Holy Cross Hospital ($7,541), Hackensack University Medical Center ($7,460), Providence Queen Of The Valley Medical Center ($7,455). Coverage: every hospital whose price file we could read.