Price AtlasInteractive atlas · All states · techysurgeon.comUpper endoscopy (EGD) with biopsy: what insurers pay
Scope of the esophagus, stomach and duodenum with biopsy. Commercial negotiated rates by hospital and market, next to Medicare for the same code.
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CPT 43239: Upper Endoscopy (Egd) With Biopsy
1510 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 | $2,346 | $506–$3,146 |
| Alaska (statewide) | 4 | — | — | — | $1,348–$6,160 |
| Arizona (statewide) | 13 | $2,167 | $2,600 | $3,508 | $603–$5,282 |
| Arkansas (statewide) | 16 | $843 | $1,020 | $1,300 | $709–$1,759 |
| Atlanta GA | 10 | $3,533 | $3,774 | $3,788 | $3,437–$3,792 |
| Austin TX | 13 | $909 | $1,838 | $3,385 | $862–$3,385 |
| Boston MA | 16 | $1,154 | $1,484 | $1,729 | $762–$2,003 |
| California (statewide) | 74 | $1,626 | $2,766 | $3,900 | $820–$8,186 |
| Charlotte NC | 6 | $1,115 | $1,115 | $1,115 | $1,099–$5,050 |
| Chicago IL | 11 | $2,642 | $3,247 | $3,622 | $1,520–$4,195 |
| Cleveland OH | 11 | $2,145 | $2,482 | $2,980 | $1,786–$3,528 |
| Colorado (statewide) | 20 | $1,342 | $2,378 | $3,145 | $866–$4,600 |
| Columbus OH | 1 | — | — | — | $6,902–$6,902 |
| Connecticut (statewide) | 3 | — | — | — | $1,228–$3,779 |
| Dallas-Fort Worth TX | 13 | $2,224 | $2,664 | $3,016 | $1,934–$4,164 |
| Delaware (statewide) | 1 | — | — | — | $2,465–$2,465 |
| Denver CO | 15 | $1,556 | $3,606 | $4,268 | $1,336–$4,600 |
| Detroit MI | 17 | $998 | $1,131 | $1,378 | $546–$2,782 |
| Florida (statewide) | 71 | $1,647 | $2,228 | $3,032 | $506–$7,541 |
| Georgia (statewide) | 45 | $2,246 | $3,258 | $3,437 | $450–$4,473 |
| Hawaii (statewide) | 8 | $2,672 | $2,982 | $3,406 | $1,279–$3,696 |
| Houston TX | 19 | $1,731 | $2,613 | $2,810 | $1,409–$3,644 |
| Idaho (statewide) | 18 | $1,022 | $1,242 | $1,978 | $777–$2,747 |
| Illinois (statewide) | 38 | $1,379 | $2,013 | $2,536 | $793–$4,622 |
| Indiana (statewide) | 45 | $1,564 | $2,202 | $3,309 | $516–$6,867 |
| Indianapolis IN | 1 | — | — | — | $3,773–$3,773 |
| Iowa (statewide) | 35 | $927 | $1,370 | $2,056 | $612–$2,987 |
| Kansas (statewide) | 47 | $1,096 | $1,334 | $1,760 | $471–$4,765 |
| Kentucky (statewide) | 21 | $1,241 | $1,750 | $2,567 | $766–$5,279 |
| Las Vegas NV | 1 | — | — | — | $2,072–$2,072 |
| Los Angeles CA | 17 | $2,625 | $3,452 | $3,654 | $1,480–$6,066 |
| Louisiana (statewide) | 25 | $916 | $1,182 | $1,477 | $633–$2,509 |
| Maine (statewide) | 17 | $3,700 | $3,842 | $4,313 | $897–$5,608 |
| Maryland (statewide) | 1 | — | — | — | $2,099–$2,099 |
| Massachusetts (statewide) | 10 | $1,052 | $1,531 | $1,912 | $871–$2,378 |
| Miami-Fort Lauderdale FL | 2 | — | — | — | $1,456–$1,973 |
| Michigan (statewide) | 34 | $930 | $1,007 | $1,414 | $498–$1,803 |
| Minneapolis-St. Paul MN | 10 | $1,743 | $2,042 | $2,220 | $1,480–$2,264 |
| Minnesota (statewide) | 29 | $1,642 | $2,270 | $2,780 | $973–$3,732 |
| Mississippi (statewide) | 25 | $1,120 | $1,503 | $1,598 | $403–$2,888 |
| Missouri (statewide) | 35 | $1,380 | $1,850 | $3,081 | $471–$6,278 |
| Montana (statewide) | 8 | $1,708 | $2,010 | $2,620 | $578–$4,764 |
| Nashville TN | 8 | $1,412 | $2,206 | $2,422 | $1,257–$2,474 |
| Nebraska (statewide) | 24 | $1,724 | $2,330 | $2,750 | $653–$3,909 |
| Nevada (statewide) | 4 | — | — | — | $1,014–$2,364 |
| New Hampshire (statewide) | 7 | $2,056 | $2,214 | $3,430 | $570–$4,062 |
| New Jersey (statewide) | 24 | $1,574 | $3,057 | $4,621 | $1,024–$8,155 |
| New Mexico (statewide) | 11 | $1,375 | $1,787 | $3,398 | $980–$4,752 |
| New York (statewide) | 39 | $1,728 | $2,198 | $2,975 | $842–$6,211 |
| New York City | 8 | $1,764 | $1,766 | $3,536 | $1,456–$7,334 |
| North Carolina (statewide) | 11 | $1,584 | $2,246 | $2,674 | $928–$4,154 |
| North Dakota (statewide) | 9 | $1,044 | $2,071 | $2,270 | $874–$3,452 |
| Ohio (statewide) | 46 | $2,110 | $2,498 | $3,610 | $542–$4,671 |
| Oklahoma (statewide) | 20 | $1,476 | $1,839 | $1,934 | $927–$5,238 |
| Oregon (statewide) | 18 | $1,797 | $2,608 | $3,249 | $812–$4,636 |
| Pennsylvania (statewide) | 51 | $1,738 | $2,523 | $3,014 | $920–$5,634 |
| Philadelphia PA | 11 | $3,282 | $3,598 | $4,385 | $2,720–$8,155 |
| Phoenix AZ | 8 | $2,658 | $2,678 | $2,706 | $2,600–$2,788 |
| Pittsburgh PA | 12 | $1,625 | $1,744 | $2,038 | $1,202–$2,634 |
| Portland OR | 9 | $4,275 | $5,158 | $5,160 | $4,275–$5,160 |
| Rhode Island (statewide) | 6 | $1,262 | $1,927 | $2,767 | $908–$2,991 |
| Richmond VA | 3 | — | — | — | $4,146–$4,816 |
| Rio Grande Valley TX | 6 | $1,190 | $1,758 | $2,818 | $1,179–$3,154 |
| Salt Lake City UT | 9 | $1,930 | $1,930 | $1,930 | $1,930–$1,930 |
| San Antonio TX | 3 | — | — | — | $1,497–$2,800 |
| San Diego CA | 7 | $1,983 | $1,983 | $1,996 | $1,668–$2,151 |
| San Francisco Bay Area CA | 5 | $3,227 | $3,387 | $5,022 | $1,601–$5,460 |
| Seattle-Tacoma WA | 16 | $2,837 | $3,033 | $3,088 | $2,535–$3,387 |
| South Carolina (statewide) | 26 | $1,800 | $2,872 | $3,641 | $749–$6,132 |
| South Dakota (statewide) | 7 | $1,698 | $2,530 | $2,702 | $1,011–$4,742 |
| St. Louis MO | 10 | $1,711 | $1,920 | $1,920 | $1,576–$2,740 |
| Tampa FL | 6 | $978 | $978 | $1,694 | $978–$4,360 |
| Tennessee (statewide) | 40 | $1,239 | $1,582 | $1,906 | $813–$2,500 |
| Texas (statewide) | 84 | $1,361 | $2,314 | $2,923 | $569–$5,496 |
| Utah (statewide) | 16 | $1,930 | $1,930 | $1,930 | $488–$3,145 |
| Vermont (statewide) | 5 | $607 | $2,380 | $3,595 | $538–$3,685 |
| Virginia (statewide) | 28 | $2,638 | $3,920 | $4,564 | $1,107–$5,051 |
| Washington (statewide) | 16 | $1,799 | $2,404 | $2,710 | $527–$4,598 |
| Washington DC | 11 | $2,485 | $2,485 | $3,084 | $2,171–$3,273 |
| West Virginia (statewide) | 11 | $1,422 | $1,528 | $2,954 | $1,041–$6,038 |
| Wisconsin (statewide) | 48 | $2,225 | $3,077 | $3,638 | $682–$5,220 |
Lowest and highest 12 hospital medians
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Wayne General Hospital | Mississippi (statewide) | $403 | 0.5× | 2 | 2026-07-31 |
| Memorial Hospital And Manor | Georgia (statewide) | $450 | 0.6× | 1 | 2026-05-01 |
| Amberwell Hiawatha | Kansas (statewide) | $471 | 0.6× | 3 | 2026-08-18 |
| Mercy Hospital Aurora | Missouri (statewide) | $471 | 0.5× | 4 | 2026-06-10 |
| Amberwell Atchison Association | Kansas (statewide) | $472 | 0.6× | 2 | 2026-08-18 |
| San Juan Hospital | Utah (statewide) | $488 | 0.5× | 14 | 2026-04-13 |
| Mitchell County Hospital Health Systems | Kansas (statewide) | $496 | 0.6× | 2 | 2026-03-21 |
| Helen Newberry Joy Hospital | Michigan (statewide) | $498 | 0.6× | 1 | 2026-09-02 |
| Usa Health Children'S & Women'S Hospital | Alabama (statewide) | $506 | 0.6× | 2 | 2026-04-30 |
| Calhoun-Liberty Hospital | Florida (statewide) | $506 | 0.5× | 1 | 2026-08-12 |
| Oaklawn Hospital | Michigan (statewide) | $507 | 0.6× | 2 | 2026-03-27 |
| Harrison County Hospital | Indiana (statewide) | $516 | 0.5× | 1 | 2026-07-16 |
| Franciscan Health Munster | Indiana (statewide) | $6,867 | 7.2× | 3 | 2026-01-01 |
| Mount Carmel East | Columbus OH | $6,902 | 7.9× | 25 | 2026-03-31 |
| Los Robles Hospital & Medical Center | California (statewide) | $7,139 | 6.1× | 4 | 2026-09-01 |
| NYU Langone Hospitals (Orthopedic Hospital + Tisch files) | New York City | $7,334 | 6.5× | 9 | 2026-01-01 |
| Hackensack University Medical Center | New Jersey (statewide) | $7,460 | 6.9× | 4 | 2025-12-31 |
| Providence Queen Of The Valley Medical Center | California (statewide) | $7,480 | 6.4× | 5 | 2026-04-01 |
| Holy Cross Hospital | Florida (statewide) | $7,541 | 8.0× | 24 | 2026-03-31 |
| Providence St Joseph Hospital | California (statewide) | $7,568 | 6.5× | 4 | 2026-04-01 |
| Providence Redwood Memorial Hospital | California (statewide) | $8,005 | 6.9× | 3 | 2026-04-01 |
| Inspira Medical Center Vineland | New Jersey (statewide) | $8,155 | 8.0× | 1 | 2026-03-24 |
| Inspira Medical Center Mullica Hill | Philadelphia PA | $8,155 | 8.0× | 1 | 2026-03-24 |
| Valley Children'S Hospital | California (statewide) | $8,186 | 7.0× | 2 | 2026-04-01 |
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) with biopsy?
Across 1510 hospitals in 81 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 43239, hospital outpatient is $2,171, 2.3× the same hospital's local Medicare base rate. The middle half of hospitals runs $1,388 to $3,077. Figures are each hospital's median across insurers, from its federal price-transparency file.
What does Medicare pay for upper endoscopy (egd) with biopsy?
Medicare's national hospital outpatient rate for CPT 43239 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) with biopsy?
Lowest medians: Wayne General Hospital ($403), Memorial Hospital And Manor ($450), Amberwell Hiawatha ($471). Highest: Valley Children'S Hospital ($8,186), Inspira Medical Center Mullica Hill ($8,155), Inspira Medical Center Vineland ($8,155). Coverage: every hospital whose price file we could read.