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What each route pays, from the published files

Upper Endoscopy (EGD) Cost in the USA: Hospital Cash Price, Insurance and Medicare

What US hospitals publish as their cash price for an upper endoscopy, the spread of rates they negotiated with insurers, and what Medicare pays a surgical center and a physician, each per billing code and with the file it was read from.

Peter Langdon · TreatCompare editor — healthcare price research

Important information for US visitors

This page is general consumer information about published US hospital charges and Medicare fee schedules. It is not insurance advice, billing advice, legal advice, tax advice, or medical advice. The calculator does arithmetic on numbers you enter; an actual bill depends on your plan, network status, prior authorization, separate professional and facility fees, and the code billed. Check any quoted price and your share with your provider and your insurer before booking care.

Could paying cash for an upper endoscopy cost less than using insurance?

It can. Compare the provider’s written cash quote with your own share under your plan (deductible left, coinsurance, copay, out-of-pocket limit), not with the hospital’s gross charge. For code 43235, the median hospital cash price in the files read is $1,610 across 55 hospitals.

How each route pays for an Upper endoscopy

One billing code, 43235 (EGD diagnostic), so every figure prices the same service. Other codes are in the tables below. Waiting times are not published by any official US source.
How each route pays for an Upper endoscopy
RouteWhat it coversWaitPriceSource
Original Medicare (Part B)Code 43235: EGD diagnosticAfter the Part B deductible, the patient usually pays 20% of the Medicare-approved amount.Where the provider accepts the Medicare-approved amount as full payment. The deductible is in the Medicare table below.Not publishedNo official US source publishes waiting times for this procedure.$497.85What Medicare pays. National rate paid to an ambulatory surgical center for the facility. The physician is paid separately (see the Medicare table).
MedicaidSet by each stateNot trackedEach state sets what its Medicaid program covers and pays. State Medicaid fee schedules have not been read.Not publishedNo official US source publishes waiting times for this procedure.Not trackedNone for this row
Employer or Marketplace health planCode 43235: EGD diagnostic. Hospital negotiated rates, no payer namedA Marketplace plan caps in-network out-of-pocket costs at $10,600 for an individual (plan year 2026).Premiums, services the plan does not cover and out-of-network care do not count toward it.Not publishedNo official US source publishes waiting times for this procedure.$1,558Median of 83 hospitals' middle negotiated rates, facility charge only, across 1,512 payer contracts; no payer is named.
Self-pay at a hospitalCode 43235: EGD diagnostic. Discounted cash priceUninsured and self-pay patients are entitled to a Good Faith Estimate of expected charges when they schedule or ask.Not publishedNo official US source publishes waiting times for this procedure.$1,610Median of 55 hospitals' discounted cash prices, facility charge only.
Self-pay at a surgical center or clinicPrices on the provider’s own siteNot trackedNot publishedNo official US source publishes waiting times for this procedure.Not trackedNo surgical center’s or clinic’s own price page has been read.None for this row
Hospital figures are facility charges from each hospital’s own file; the physician’s bill is separate. Medicare amounts are national, before geographic adjustment.

First question

Which code?

A diagnostic EGD, an EGD with biopsy and an EGD with dilation are different codes.

Separate bills

Anesthesia

Anesthesia is usually a separate bill from the gastroenterologist and the facility.

Samples taken

Pathology

A biopsy generates a separate pathology bill.

What hospitals publish for an Upper endoscopy, by billing code

Read from each hospital’s standard-charge file, which federal rules (45 CFR 180.50) require it to publish. One figure per hospital and code, the hospital’s facility charge. A median is given only where at least 4 hospitals publish; below that each hospital is named with its own figure. Cash prices and negotiated rates are never combined, and no insurer is named.

109 of 238 hospitals in our source registry for the US publish a figure for these codes in the files read.

Across all procedures: 183 of 238 hospitals, 51 of 51 states.

CodeHospital cash priceHospital negotiated ratesWhat Medicare pays (national)
43235EGD diagnostic
Median $1,61055 hospitals; lowest $191, highest $14,673
Median $1,55883 hospitals; lowest $616, highest $13,697
$497.85Surgical center facility rate
43239EGD with biopsy
Median $2,05759 hospitals; lowest $320, highest $14,424
Median $1,47688 hospitals; lowest $616, highest $14,262
$497.85Surgical center facility rate
43249EGD with dilation
Median $2,60156 hospitals; lowest $325, highest $17,729
Median $2,37389 hospitals; lowest $959, highest $14,262
$894.33Surgical center facility rate

The negotiated figure for each hospital is the middle of the rates it lists across its payers. It is what an insurer pays the hospital, not what a patient on that plan pays. The lowest and highest figures are single hospitals’ and are shown so they can be checked against the file.

Code 43235: every hospital and its file
HospitalCash priceNegotiated (middle; no payer named)File, read
AdventHealth OrlandoOrlando, FL$3,055$1,0046 payersurldefense.comread 2026-11-06; file dated 2026-04-01
Advocate Christ Medical CenterOak Lawn, ILNot counted$1,8668 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-03
Aurora St. Luke's Medical CenterMilwaukee, WINot counted$3,02715 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-05
Banner - University Medical Center PhoenixPhoenix, AZNot counted$96823 payersimages.pricetransparency.healthcareread 2026-11-06; file dated 2026-09-25
Baptist Memorial Hospital-DeSotoSouthaven, MS$191$1,54584 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Bayhealth Medical Center Kent CampusDover, DE$2,236$1,0324 payersbayhealth.orgread 2026-11-06; file dated 2026-04-01
Beaumont Hospital Royal OakRoyal Oak, MINot counted$9048 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Central Vermont Medical CenterBerlin, VT$3,303$2,13012 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-01
Cheyenne Regional Medical CenterCheyenne, WY$2,205$2,62010 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-25
Christiana HospitalNewark, DENot counted$1,0596 payersdocuments.christianacare.orgread 2026-11-06; file dated 2026-04-01
Cleveland Clinic FloridaWeston, FL$3,504$1,62322 payersclevelandclinic.pt.panaceainc.comread 2026-11-06; file dated 2026-06-15
Cleveland Clinic Main CampusCleveland, OH$2,803$2,09646 payersclevelandclinic.pt.panaceainc.comread 2026-10-26; file dated 2026-06-16
Corewell Health Butterworth HospitalGrand Rapids, MINot counted$1,7654 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Covenant Health Hobbs HospitalHobbs, NM$957$9456 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
DCH Regional Medical CenterTuscaloosa, AL$679$90415 payersdch.pt.panaceainc.comread 2026-10-26; file dated 2026-03-26
Denver Health Medical CenterDenver, CO$565$1,5588 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-04-30
Duke University HospitalDurham, NC$813$91115 payersrca.elevatepfs.comread 2026-11-06; file dated 2026-04-01
Elliot HospitalManchester, NH$1,228$1,0705 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Endeavor Health Evanston HospitalEvanston, ILNot counted$9723 payersendeavorhealth.orgread 2026-11-06; file dated 2026-04-01
Essentia Health-FargoFargo, ND$1,762$1,00743 payersessentiahealth.orgread 2026-11-06; file dated 2026-01-01
Froedtert HospitalMilwaukee, WI$1,554$1,75233 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-12-31
Grady Memorial HospitalAtlanta, GA$3,678$1,63718 payersgradyhealth.orgread 2026-11-06; file dated 2026-01-01
Hackensack University Medical CenterHackensack, NJ$1,104$3,80522 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Hennepin HealthcareMinneapolis, MNNot counted$1,0058 payershennepinhealthcare.pt.panaceainc.comread 2026-10-26; file dated 2025-12-17
Henry Ford HospitalDetroit, MI$1,247$90424 payershenryford.comread 2026-10-26; file dated 2026-06-28
HonorHealth Scottsdale Shea Medical CenterScottsdale, AZNot counted$1,4198 payershonorhealth.comread 2026-11-06; file dated 2026-04-01
Hospital of the University of PennsylvaniaPhiladelphia, PA$938$75081 payerstupa-q-001.sitecorecontenthub.cloudread 2026-11-06; file dated 2026-10-20
Houston Methodist HospitalHouston, TX$426$1,79712 payershoustonmethodist.orgread 2026-11-06; file dated 2026-04-01
INTEGRIS Baptist Medical CenterOklahoma City, OKNot counted$4,0647 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Jersey Shore University Medical CenterNeptune, NJ$1,038$3,47820 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Legacy Emanuel Medical CenterPortland, ORNot counted$2,21511 payerslegacyhealth.orgread 2026-11-06; file dated 2026-04-01
Lovelace Medical CenterAlbuquerque, NM$1,220$2,0335 payerscdn.ardenthealthservices.comread 2026-11-06; file dated 2026-03-31
Maine Medical CenterPortland, MENot counted$9075 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-09-09
MD Anderson Cancer CenterHouston, TXNot counted$2,17425 payersmdanderson.orgread 2026-11-06; file dated 2026-10-01
MedStar Georgetown University HospitalWashington, DC$1,463$1,59920 payersmedstarhealth.orgread 2026-11-06; file dated 2026-04-01
MedStar Washington Hospital CenterWashington, DC$1,098$1,12521 payersmedstarhealth.orgread 2026-11-06; file dated 2026-04-01
Memorial Hermann-Texas Medical CenterHouston, TX$1,456$1,3674 payersmemorialhermann.orgread 2026-11-06; file dated 2026-04-01
Memorial Medical Center Las CrucesLas Cruces, NM$7,325$4,0681 payersmmclc.orgread 2026-11-06; file dated 2026-07-10
MercyOne Des Moines Medical CenterDes Moines, IA$14,673$92781 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Mississippi Baptist Medical CenterJackson, MSNot counted$1,53262 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-25
MUSC Health University Medical CenterCharleston, SCNot counted$8445 payersd3crna64wemw02.cloudfront.netread 2026-11-06; file dated 2026-04-01
Nashville General HospitalNashville, TN$1,774$1,21810 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-09-01
NEA Baptist Memorial HospitalJonesboro, ARNot counted$1,29668 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Newport HospitalNewport, RI$3,153also The Miriam Hospital (same file host, counted once)$1,8466 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
North Memorial Health HospitalRobbinsdale, MN$1,384$98410 payersnorthmemorial.comread 2026-11-06; file dated 2026-09-25
North Mississippi Medical CenterTupelo, MS$973$1,4208 payersapps.nmhs.netread 2026-11-06; file dated 2026-04-01
Northern Light Eastern Maine Medical CenterBangor, ME$971$3,0048 payersnorthernlighthealth.orgread 2026-11-06; file dated 2026-02-03
Norton Children's HospitalLouisville, KYNot counted$8794 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-02-11
Novant Health Forsyth Medical CenterWinston-Salem, NCNot counted$8808 payerswww2.novanthealth.orgread 2026-10-26; file dated 2026-03-30
Phoenix Children's HospitalPhoenix, AZNot counted$61619 payersphoenixchildrens.pt.panaceainc.comread 2026-10-26; file dated 2026-01-01
Porter Medical CenterMiddlebury, VT$2,880$1,58417 payersuvmhealth.orgread 2026-11-06; file dated 2026-04-28
Providence Alaska Medical CenterAnchorage, AKNot counted$4,4732 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Regional Medical Center EverettEverett, WANot counted$1,90511 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Sacred Heart Medical CenterSpokane, WA$1,583$1,82111 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Robert Wood Johnson University HospitalNew Brunswick, NJ$5,741$4,09410 payersmrfs.hyvehealthcare.comread 2026-11-06; file dated 2026-03-04
Saint Alphonsus Regional Medical CenterBoise, ID$2,785$97920 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital and Medical CenterHartford, CT$6,671$3,77989 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital TulsaTulsa, OKNot counted$1,6884 payerssaintfrancis.comread 2026-11-06; file dated 2026-04-01
Sanford Aberdeen Medical CenterAberdeen, SDNot counted$9668 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-04
Sanford USD Medical CenterSioux Falls, SD$2,539$98414 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-03-04
Sentara Norfolk General HospitalNorfolk, VANot counted$2,8115 payerssentara.comread 2026-11-06; file dated 2026-04-01
South County HospitalWakefield, RI$3,101$9245 payersstdidsouthcountyhealprod.blob.core.windows.netread 2026-11-06; file dated 2026-07-24
St. Patrick HospitalMissoula, MT$990$9545 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Stanford HospitalStanford, CA$3,788$13,6975 payersstanfordhealthcare.orgread 2026-11-06; file dated 2026-04-01
Tampa General HospitalTampa, FL$502$1,20420 payerstgh.orgread 2026-11-06; file dated 2026-04-01
The Miriam HospitalProvidence, RINot counted$1,8647 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
The Mount Sinai HospitalNew York, NY$2,187$3,3677 payersmountsinai.orgread 2026-11-06; file dated 2026-04-01
Trinity HospitalsMinot, ND$1,465$9271 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
UCHealth University of Colorado HospitalAurora, CO$1,425$1,63226 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-11-01
UCSF Medical CenterSan Francisco, CA$869$2,6545 payersapp.box.comread 2026-11-06; file dated 2026-04-01
UnityPoint Health - MeriterMadison, WI$3,541$1,38114 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
UnityPoint Health Iowa Lutheran HospitalDes Moines, IA$1,659$97315 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-04
UnityPoint Health Iowa Methodist Medical CenterDes Moines, IA$1,610$95610 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
University Medical Center of Southern NevadaLas Vegas, NV$1,088$1,72988 payersmrfs.hyvehealthcare.comread 2026-10-26; file dated 2026-07-01
University of Iowa Hospitals & ClinicsIowa City, IA$2,383$2,21323 payershealthcare.uiowa.eduread 2026-10-26; file dated 2026-02-27
University of Michigan Health SystemAnn Arbor, MI$1,618$2,83224 payersuofmhealth.orgread 2026-11-06; file dated 2026-03-31
University of Vermont Medical CenterBurlington, VT$3,174$1,58717 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-12
UofL Health Jewish HospitalLouisville, KYNot counted$92314 payersuoflhealth.orgread 2026-11-06; file dated 2026-01-01
UPMC PresbyterianPittsburgh, PA$3,236$96523 payersdam.upmc.comread 2026-10-26; file dated 2026-03-06
UT Southwestern University HospitalsDallas, TX$1,526$1,63122 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-10
Vanderbilt University Medical CenterNashville, TNNot counted$1,96413 payersfinance.vumc.orgread 2026-11-06; file dated 2026-10-01
Virginia Mason Medical CenterSeattle, WA$1,736$2,33612 payersvmfh.orgread 2026-11-06; file dated 2026-01-01
Wellstar Kennestone Regional Medical CenterMarietta, GANot counted$1,7048 payerswellstar.orgread 2026-11-06; file dated 2026-04-01

Not counted, because the file lists several different charge lines for this code: Baptist Health Princeton Hospital (AL, 2 lines); Beebe Medical Center (DE, 2 lines); Emory University Hospital (GA, 3 lines); Eskenazi Health (IN, 2 lines); M Health Fairview University of Minnesota Medical Center (MN, 4 lines); Mercy Hospital Fort Smith (AR, 2 lines); Mercy Hospital Oklahoma City (OK, 2 lines); Mercy Hospital Springfield (MO, 2 lines); Mercy Hospital St. Louis (MO, 4 lines); MetroHealth Medical Center (OH, 2 lines); Nebraska Methodist Hospital (NE, 2 lines); Northern Light Mercy Hospital (ME, 2 lines); OU Health University of Oklahoma Medical Center (OK, 5 lines); Providence Portland Medical Center (OR, 2 lines); Providence St. Vincent Medical Center (OR, 2 lines); Rhode Island Hospital (RI, 2 lines); Southwestern Vermont Medical Center (VT, 2 lines); Swedish Medical Center First Hill (WA, 2 lines); The Queen's Medical Center (HI, 3 lines); Thomas Jefferson University Hospital (PA, 2 lines); UAMS Medical Center (AR, 2 lines); UConn Health, Waterbury Hospital (CT, 2 lines); University of Chicago Medical Center (IL, 4 lines); West Virginia University Hospitals (WV, 2 lines).

Code 43239: every hospital and its file
HospitalCash priceNegotiated (middle; no payer named)File, read
AdventHealth OrlandoOrlando, FL$3,055$1,0046 payersurldefense.comread 2026-11-06; file dated 2026-04-01
Advocate Christ Medical CenterOak Lawn, ILNot counted$1,8668 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-03
Aurora St. Luke's Medical CenterMilwaukee, WINot counted$3,03515 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-05
Banner - University Medical Center PhoenixPhoenix, AZNot counted$96823 payersimages.pricetransparency.healthcareread 2026-11-06; file dated 2026-09-25
Baptist Memorial Hospital-DeSotoSouthaven, MSNot counted$1,54576 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Bayhealth Medical Center Kent CampusDover, DE$2,236$1,0324 payersbayhealth.orgread 2026-11-06; file dated 2026-04-01
Beaumont Hospital Royal OakRoyal Oak, MINot counted$9048 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Central Vermont Medical CenterBerlin, VT$3,303$2,13012 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-01
Cheyenne Regional Medical CenterCheyenne, WY$2,702$3,21110 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-25
Christiana HospitalNewark, DENot counted$1,0596 payersdocuments.christianacare.orgread 2026-11-06; file dated 2026-04-01
Cleveland Clinic FloridaWeston, FL$3,504$1,53622 payersclevelandclinic.pt.panaceainc.comread 2026-11-06; file dated 2026-06-15
Cleveland Clinic Main CampusCleveland, OH$2,803$2,09646 payersclevelandclinic.pt.panaceainc.comread 2026-10-26; file dated 2026-06-16
Corewell Health Butterworth HospitalGrand Rapids, MINot counted$1,7654 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Covenant Health Hobbs HospitalHobbs, NM$957$9456 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
DCH Regional Medical CenterTuscaloosa, AL$665$90415 payersdch.pt.panaceainc.comread 2026-10-26; file dated 2026-03-26
Denver Health Medical CenterDenver, CO$565$1,5588 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-04-30
Duke University HospitalDurham, NC$813$90215 payersrca.elevatepfs.comread 2026-11-06; file dated 2026-04-01
Elliot HospitalManchester, NH$1,517$1,0705 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Endeavor Health Evanston HospitalEvanston, ILNot counted$9723 payersendeavorhealth.orgread 2026-11-06; file dated 2026-04-01
Erlanger Baroness HospitalChattanooga, TNNot counted$86020 payerserlanger.pt.panaceainc.comread 2026-10-26; file dated 2026-01-25
Essentia Health-FargoFargo, ND$2,322$1,32843 payersessentiahealth.orgread 2026-11-06; file dated 2026-01-01
Froedtert HospitalMilwaukee, WINot counted$95317 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-12-31
Grady Memorial HospitalAtlanta, GANot counted$1,22016 payersgradyhealth.orgread 2026-11-06; file dated 2026-01-01
Hackensack University Medical CenterHackensack, NJ$1,104$3,49022 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Hennepin HealthcareMinneapolis, MN$770$9808 payershennepinhealthcare.pt.panaceainc.comread 2026-10-26; file dated 2025-12-17
Henry Ford HospitalDetroit, MI$1,247$90424 payershenryford.comread 2026-10-26; file dated 2026-06-28
HonorHealth Scottsdale Shea Medical CenterScottsdale, AZ$2,407$1,4198 payershonorhealth.comread 2026-11-06; file dated 2026-04-01
Houston Methodist HospitalHouston, TX$405$1,96812 payershoustonmethodist.orgread 2026-11-06; file dated 2026-04-01
INTEGRIS Baptist Medical CenterOklahoma City, OKNot counted$4,3937 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Jersey Shore University Medical CenterNeptune, NJ$1,038$3,21520 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Legacy Emanuel Medical CenterPortland, ORNot counted$2,21511 payerslegacyhealth.orgread 2026-11-06; file dated 2026-04-01
Lovelace Medical CenterAlbuquerque, NM$1,341$2,2355 payerscdn.ardenthealthservices.comread 2026-11-06; file dated 2026-03-31
Maine Medical CenterPortland, MENot counted$9075 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-09-09
MD Anderson Cancer CenterHouston, TXNot counted$2,54025 payersmdanderson.orgread 2026-11-06; file dated 2026-10-01
MedStar Georgetown University HospitalWashington, DC$1,636$1,62619 payersmedstarhealth.orgread 2026-11-06; file dated 2026-04-01
MedStar Washington Hospital CenterWashington, DC$1,908$1,75321 payersmedstarhealth.orgread 2026-11-06; file dated 2026-04-01
Memorial Hermann-Texas Medical CenterHouston, TX$1,541$1,3674 payersmemorialhermann.orgread 2026-11-06; file dated 2026-04-01
Memorial Medical Center Las CrucesLas Cruces, NM$10,679$4,0681 payersmmclc.orgread 2026-11-06; file dated 2026-07-10
Mercy Hospital Fort SmithFort Smith, AR$4,094$86277 payersmercy.netread 2026-11-06; file dated 2026-06-08
Mercy Hospital Oklahoma CityOklahoma City, OK$3,663$83953 payersmercy.netread 2026-11-06; file dated 2026-06-12
Mercy Hospital SpringfieldSpringfield, MO$4,107$89176 payersmercy.netread 2026-11-06; file dated 2026-06-04
MercyOne Des Moines Medical CenterDes Moines, IA$14,424$92782 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Mississippi Baptist Medical CenterJackson, MSNot counted$1,53262 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-25
MUSC Health University Medical CenterCharleston, SCNot counted$8565 payersd3crna64wemw02.cloudfront.netread 2026-11-06; file dated 2026-04-01
Nashville General HospitalNashville, TN$1,824$1,21810 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-09-01
NEA Baptist Memorial HospitalJonesboro, ARNot counted$1,29668 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Newport HospitalNewport, RI$3,153also The Miriam Hospital (same file host, counted once)$1,8466 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
North Memorial Health HospitalRobbinsdale, MN$2,511$98410 payersnorthmemorial.comread 2026-11-06; file dated 2026-09-25
North Mississippi Medical CenterTupelo, MS$1,162$1,4208 payersapps.nmhs.netread 2026-11-06; file dated 2026-04-01
Northern Light Mercy HospitalPortland, ME$1,203$3,0078 payersnorthernlighthealth.orgread 2026-11-06; file dated 2026-04-15
Norton Children's HospitalLouisville, KYNot counted$8794 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-02-11
Novant Health Forsyth Medical CenterWinston-Salem, NCNot counted$8808 payerswww2.novanthealth.orgread 2026-10-26; file dated 2026-03-30
Phoenix Children's HospitalPhoenix, AZNot counted$61619 payersphoenixchildrens.pt.panaceainc.comread 2026-10-26; file dated 2026-01-01
Porter Medical CenterMiddlebury, VT$3,910$2,15117 payersuvmhealth.orgread 2026-11-06; file dated 2026-04-28
Providence Alaska Medical CenterAnchorage, AKNot counted$6,8262 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Portland Medical CenterPortland, OR$1,548also Providence St. Vincent Medical Center (same file host, counted once)$3,3309 payersalso Providence St. Vincent Medical Center (same file host, counted once)pricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Regional Medical Center EverettEverett, WANot counted$1,90511 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Sacred Heart Medical CenterSpokane, WA$2,057$1,82111 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Robert Wood Johnson University HospitalNew Brunswick, NJ$5,741$4,09411 payersmrfs.hyvehealthcare.comread 2026-11-06; file dated 2026-03-04
Saint Alphonsus Regional Medical CenterBoise, ID$4,779$97920 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital and Medical CenterHartford, CT$8,891$3,77989 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital TulsaTulsa, OK$320$1,6884 payerssaintfrancis.comread 2026-11-06; file dated 2026-04-01
Sanford Aberdeen Medical CenterAberdeen, SDNot counted$9668 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-04
Sanford USD Medical CenterSioux Falls, SD$2,540$98414 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-03-04
Sentara Norfolk General HospitalNorfolk, VANot counted$2,8115 payerssentara.comread 2026-11-06; file dated 2026-04-01
South County HospitalWakefield, RI$3,101$9595 payersstdidsouthcountyhealprod.blob.core.windows.netread 2026-11-06; file dated 2026-07-24
St. Patrick HospitalMissoula, MT$990$9545 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Stanford HospitalStanford, CA$4,007$14,2625 payersstanfordhealthcare.orgread 2026-11-06; file dated 2026-04-01
Swedish Medical Center First HillSeattle, WA$1,829$2,41416 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Tampa General HospitalTampa, FL$706$1,42120 payerstgh.orgread 2026-11-06; file dated 2026-04-01
The Miriam HospitalProvidence, RINot counted$1,8647 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
Trinity HospitalsMinot, ND$1,604$9271 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
UCHealth University of Colorado HospitalAurora, CO$1,601$1,69226 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-11-01
UCSF Medical CenterSan Francisco, CANot counted$2,6545 payersapp.box.comread 2026-11-06; file dated 2026-04-01
United Hospital CenterBridgeport, WV$1,347$98222 payerswvumedicine.orgread 2026-11-06; file dated 2026-07-10
UnityPoint Health - MeriterMadison, WI$3,541$1,38114 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
UnityPoint Health Iowa Lutheran HospitalDes Moines, IA$4,116$99115 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-04
UnityPoint Health Iowa Methodist Medical CenterDes Moines, IA$3,997$1,21210 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
University Medical Center of Southern NevadaLas Vegas, NV$1,814$2,01588 payersmrfs.hyvehealthcare.comread 2026-10-26; file dated 2026-07-01
University of Iowa Hospitals & ClinicsIowa City, IA$2,833$2,63123 payershealthcare.uiowa.eduread 2026-10-26; file dated 2026-02-27
University of Michigan Health SystemAnn Arbor, MI$1,541$2,69724 payersuofmhealth.orgread 2026-11-06; file dated 2026-03-31
University of Vermont Medical CenterBurlington, VT$3,165$1,58317 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-12
UofL Health Jewish HospitalLouisville, KYNot counted$92314 payersuoflhealth.orgread 2026-11-06; file dated 2026-01-01
UPMC PresbyterianPittsburgh, PA$4,331$96523 payersdam.upmc.comread 2026-10-26; file dated 2026-03-06
UT Southwestern University HospitalsDallas, TX$2,594$2,51122 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-10
Vanderbilt University Medical CenterNashville, TNNot counted$2,00313 payersfinance.vumc.orgread 2026-11-06; file dated 2026-10-01
Virginia Mason Medical CenterSeattle, WA$1,928$2,44512 payersvmfh.orgread 2026-11-06; file dated 2026-01-01
Wellstar Kennestone Regional Medical CenterMarietta, GA$1,406$1,7048 payerswellstar.orgread 2026-11-06; file dated 2026-04-01

Not counted, because the file lists several different charge lines for this code: Baptist Health Princeton Hospital (AL, 2 lines); Beebe Medical Center (DE, 3 lines); Emory University Hospital (GA, 2 lines); Eskenazi Health (IN, 2 lines); M Health Fairview University of Minnesota Medical Center (MN, 9 lines); Mercy Hospital St. Louis (MO, 3 lines); MetroHealth Medical Center (OH, 2 lines); Nebraska Methodist Hospital (NE, 2 lines); Northern Light Eastern Maine Medical Center (ME, 2 lines); OU Health University of Oklahoma Medical Center (OK, 5 lines); Rhode Island Hospital (RI, 2 lines); Southwestern Vermont Medical Center (VT, 2 lines); The Mount Sinai Hospital (NY, 2 lines); The Queen's Medical Center (HI, 2 lines); Thomas Jefferson University Hospital (PA, 2 lines); UAMS Medical Center (AR, 2 lines); UConn Health, Waterbury Hospital (CT, 2 lines); University of Chicago Medical Center (IL, 3 lines); West Virginia University Hospitals (WV, 2 lines).

Code 43249: every hospital and its file
HospitalCash priceNegotiated (middle; no payer named)File, read
AdventHealth OrlandoOrlando, FL$6,131$2,1246 payersurldefense.comread 2026-11-06; file dated 2026-04-01
Advocate Christ Medical CenterOak Lawn, ILNot counted$3,3908 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-03
Aurora St. Luke's Medical CenterMilwaukee, WINot counted$3,03515 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-05
Banner - University Medical Center PhoenixPhoenix, AZNot counted$2,04823 payersimages.pricetransparency.healthcareread 2026-11-06; file dated 2026-09-25
Baptist Health Princeton HospitalBirmingham, AL$6,975$1,7785 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Baptist Memorial Hospital-DeSotoSouthaven, MSNot counted$3,12776 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Bayhealth Medical Center Kent CampusDover, DE$2,236$2,1834 payersbayhealth.orgread 2026-11-06; file dated 2026-04-01
Beaumont Hospital Royal OakRoyal Oak, MINot counted$1,1318 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Central Vermont Medical CenterBerlin, VT$4,325$3,11412 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-01
Cheyenne Regional Medical CenterCheyenne, WY$2,447$2,90810 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-25
Christiana HospitalNewark, DENot counted$2,2406 payersdocuments.christianacare.orgread 2026-11-06; file dated 2026-04-01
Cleveland Clinic FloridaWeston, FL$7,090$2,93222 payersclevelandclinic.pt.panaceainc.comread 2026-11-06; file dated 2026-06-15
Cleveland Clinic Main CampusCleveland, OH$5,672$4,24146 payersclevelandclinic.pt.panaceainc.comread 2026-10-26; file dated 2026-06-16
Corewell Health Butterworth HospitalGrand Rapids, MINot counted$1,6334 payersassets.contentstack.ioread 2026-11-06; file dated 2026-05-01
Covenant Health Hobbs HospitalHobbs, NM$1,762$1,9996 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
DCH Regional Medical CenterTuscaloosa, AL$2,167$1,95215 payersdch.pt.panaceainc.comread 2026-10-26; file dated 2026-03-26
Denver Health Medical CenterDenver, CO$1,417$3,2008 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-04-30
Duke University HospitalDurham, NC$1,706$1,84415 payersrca.elevatepfs.comread 2026-11-06; file dated 2026-04-01
Elliot HospitalManchester, NH$1,377$2,2645 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Endeavor Health Evanston HospitalEvanston, ILNot counted$2,0563 payersendeavorhealth.orgread 2026-11-06; file dated 2026-04-01
Erlanger Baroness HospitalChattanooga, TNNot counted$1,79219 payerserlanger.pt.panaceainc.comread 2026-10-26; file dated 2026-01-25
Essentia Health-FargoFargo, ND$2,780$1,89743 payersessentiahealth.orgread 2026-11-06; file dated 2026-01-01
Froedtert HospitalMilwaukee, WINot counted$1,92817 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-12-31
Grady Memorial HospitalAtlanta, GANot counted$2,30415 payersgradyhealth.orgread 2026-11-06; file dated 2026-01-01
Hackensack University Medical CenterHackensack, NJ$2,234$2,94522 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Hennepin HealthcareMinneapolis, MNNot counted$1,9848 payershennepinhealthcare.pt.panaceainc.comread 2026-10-26; file dated 2025-12-17
Henry Ford HospitalDetroit, MI$2,639$1,87424 payershenryford.comread 2026-10-26; file dated 2026-06-28
HonorHealth Scottsdale Shea Medical CenterScottsdale, AZNot counted$2,4218 payershonorhealth.comread 2026-11-06; file dated 2026-04-01
Houston Methodist HospitalHouston, TX$506$3,57812 payershoustonmethodist.orgread 2026-11-06; file dated 2026-04-01
INTEGRIS Baptist Medical CenterOklahoma City, OKNot counted$4,3937 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
Jersey Shore University Medical CenterNeptune, NJ$2,100$2,74920 payershackensackmeridianhealth.orgread 2026-11-06; file dated 2025-12-31
Legacy Emanuel Medical CenterPortland, ORNot counted$4,27511 payerslegacyhealth.orgread 2026-11-06; file dated 2026-04-01
Lovelace Medical CenterAlbuquerque, NM$1,645$2,7425 payerscdn.ardenthealthservices.comread 2026-11-06; file dated 2026-03-31
Maine Medical CenterPortland, MENot counted$1,8365 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-09-09
MD Anderson Cancer CenterHouston, TXNot counted$3,41725 payersmdanderson.orgread 2026-11-06; file dated 2026-10-01
Memorial Hermann-Texas Medical CenterHouston, TX$1,541$2,8914 payersmemorialhermann.orgread 2026-11-06; file dated 2026-04-01
Memorial Medical Center Las CrucesLas Cruces, NM$11,807$4,0681 payersmmclc.orgread 2026-11-06; file dated 2026-07-10
Mercy Hospital Fort SmithFort Smith, AR$3,450$1,82380 payersmercy.netread 2026-11-06; file dated 2026-06-08
Mercy Hospital Oklahoma CityOklahoma City, OK$3,905$1,77456 payersmercy.netread 2026-11-06; file dated 2026-06-12
Mercy Hospital SpringfieldSpringfield, MO$3,394$1,88579 payersmercy.netread 2026-11-06; file dated 2026-06-04
MercyOne Des Moines Medical CenterDes Moines, IA$17,729$1,96082 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Mississippi Baptist Medical CenterJackson, MSNot counted$3,10062 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-25
MUSC Health University Medical CenterCharleston, SCNot counted$1,1745 payersd3crna64wemw02.cloudfront.netread 2026-11-06; file dated 2026-04-01
Nashville General HospitalNashville, TN$1,895$2,02510 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-09-01
NEA Baptist Memorial HospitalJonesboro, ARNot counted$2,62268 payerssites.bmhcc.orgread 2026-11-06; file dated 2026-02-27
Newport HospitalNewport, RI$4,327also The Miriam Hospital (same file host, counted once)$2,2066 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
North Memorial Health HospitalRobbinsdale, MN$2,605$1,97710 payersnorthmemorial.comread 2026-11-06; file dated 2026-09-25
North Mississippi Medical CenterTupelo, MS$1,935$3,0048 payersapps.nmhs.netread 2026-11-06; file dated 2026-04-01
Northern Light Eastern Maine Medical CenterBangor, ME$1,090$3,3748 payersnorthernlighthealth.orgread 2026-11-06; file dated 2026-02-03
Northern Light Mercy HospitalPortland, ME$1,332$3,3308 payersnorthernlighthealth.orgread 2026-11-06; file dated 2026-04-15
Norton Children's HospitalLouisville, KYNot counted$1,7784 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-02-11
Novant Health Forsyth Medical CenterWinston-Salem, NCNot counted$1,8618 payerswww2.novanthealth.orgread 2026-10-26; file dated 2026-03-30
Phoenix Children's HospitalPhoenix, AZNot counted$1,74119 payersphoenixchildrens.pt.panaceainc.comread 2026-10-26; file dated 2026-01-01
Porter Medical CenterMiddlebury, VT$4,688$2,57817 payersuvmhealth.orgread 2026-11-06; file dated 2026-04-28
Providence Alaska Medical CenterAnchorage, AKNot counted$6,8262 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Portland Medical CenterPortland, OR$3,668also Providence St. Vincent Medical Center (same file host, counted once)$5,7269 payersalso Providence St. Vincent Medical Center (same file host, counted once)pricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Regional Medical Center EverettEverett, WANot counted$3,99911 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Providence Sacred Heart Medical CenterSpokane, WA$4,341$3,84911 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Robert Wood Johnson University HospitalNew Brunswick, NJ$5,741$4,32210 payersmrfs.hyvehealthcare.comread 2026-11-06; file dated 2026-03-04
Saint Alphonsus Regional Medical CenterBoise, ID$4,200$2,07120 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital and Medical CenterHartford, CT$13,093$7,99589 payershpt.trinity-health.orgread 2026-11-06; file dated 2026-03-31
Saint Francis Hospital TulsaTulsa, OK$325$3,3174 payerssaintfrancis.comread 2026-11-06; file dated 2026-04-01
Sanford Aberdeen Medical CenterAberdeen, SDNot counted$1,9548 payersalso Sanford USD Medical Center (same file host, counted once)sthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-04
Sentara Norfolk General HospitalNorfolk, VANot counted$4,5645 payerssentara.comread 2026-11-06; file dated 2026-04-01
South County HospitalWakefield, RI$3,048$9595 payersstdidsouthcountyhealprod.blob.core.windows.netread 2026-11-06; file dated 2026-07-24
Southwestern Vermont Medical CenterBennington, VT$392$1,46612 payerssvmc.orgread 2026-11-06; file dated 2026-10-15
St. Patrick HospitalMissoula, MT$2,090$2,0195 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Stanford HospitalStanford, CA$5,226$14,2625 payersstanfordhealthcare.orgread 2026-11-06; file dated 2026-04-01
Swedish Medical Center First HillSeattle, WANot counted$5,06816 payerspricetransparency.providence.orgread 2026-11-06; file dated 2026-04-01
Tampa General HospitalTampa, FL$706$2,12120 payerstgh.orgread 2026-11-06; file dated 2026-04-01
The Miriam HospitalProvidence, RINot counted$3,6947 payersbrownhealth.orgread 2026-11-06; file dated 2026-04-01
The Mount Sinai HospitalNew York, NYNot counted$4,9987 payersmountsinai.orgread 2026-11-06; file dated 2026-04-01
Trinity HospitalsMinot, ND$3,199$1,9601 payershospitalpricedisclosure.comread 2026-11-06; file dated 2026-04-01
UCHealth University of Colorado HospitalAurora, CO$1,776$1,96426 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2025-11-01
UConn Health, Waterbury HospitalWaterbury, CT$3,028$3,3626 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-05-13
UCSF Medical CenterSan Francisco, CA$1,297$5,6145 payersapp.box.comread 2026-11-06; file dated 2026-04-01
UnityPoint Health - MeriterMadison, WI$5,446$2,12414 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
UnityPoint Health Iowa Lutheran HospitalDes Moines, IA$2,243$2,05815 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-11-04
UnityPoint Health Iowa Methodist Medical CenterDes Moines, IA$2,178$1,93510 payerssthpiprd.blob.core.windows.netread 2026-10-26; file dated 2026-01-28
University Medical Center of Southern NevadaLas Vegas, NV$2,201$2,44488 payersmrfs.hyvehealthcare.comread 2026-10-26; file dated 2026-07-01
University of Iowa Hospitals & ClinicsIowa City, IA$2,868$2,66323 payershealthcare.uiowa.eduread 2026-10-26; file dated 2026-02-27
University of Michigan Health SystemAnn Arbor, MI$1,688$2,95424 payersuofmhealth.orgread 2026-11-06; file dated 2026-03-31
University of Vermont Medical CenterBurlington, VT$4,130$2,56817 payersuvmhealth.orgread 2026-11-06; file dated 2026-10-12
UofL Health Jewish HospitalLouisville, KYNot counted$1,86714 payersuoflhealth.orgread 2026-11-06; file dated 2026-01-01
UPMC PresbyterianPittsburgh, PA$4,681$1,98922 payersdam.upmc.comread 2026-10-26; file dated 2026-03-06
UT Southwestern University HospitalsDallas, TX$2,024$2,16422 payerssthpiprd.blob.core.windows.netread 2026-11-06; file dated 2026-03-10
Vanderbilt University Medical CenterNashville, TNNot counted$2,37313 payersfinance.vumc.orgread 2026-11-06; file dated 2026-10-01
Virginia Mason Medical CenterSeattle, WA$2,596$3,56412 payersvmfh.orgread 2026-11-06; file dated 2026-01-01
Wellstar Kennestone Regional Medical CenterMarietta, GANot counted$3,4378 payerswellstar.orgread 2026-11-06; file dated 2026-04-01

Not counted, because the file lists several different charge lines for this code: Beebe Medical Center (DE, 2 lines); Emory University Hospital (GA, 2 lines); Eskenazi Health (IN, 2 lines); M Health Fairview University of Minnesota Medical Center (MN, 4 lines); Mercy Hospital St. Louis (MO, 3 lines); MetroHealth Medical Center (OH, 2 lines); Nebraska Methodist Hospital (NE, 2 lines); OU Health University of Oklahoma Medical Center (OK, 4 lines); Rhode Island Hospital (RI, 2 lines); The Queen's Medical Center (HI, 3 lines); Thomas Jefferson University Hospital (PA, 2 lines); UAMS Medical Center (AR, 2 lines); University of Chicago Medical Center (IL, 3 lines); West Virginia University Hospitals (WV, 3 lines).

What Medicare pays for an Upper endoscopy

This is what Medicare pays under its national fee schedule, before geographic adjustment. It is not a price charged to patients or to anyone without Medicare.

CodeSurgical center facility ratePhysician, in a facilityPhysician, in an office
43235EGD diagnostic$497.85$110.56$322.65
43239EGD with biopsy$497.85$123.58$418.85
43249EGD with dilation$894.33$136.28$1,180.39

Physician amounts: CMS Physician Fee Schedule, relative value file RVU26D, released August 26, 2026, read October 26, 2026. Computed by CMS’s formula with the file’s own conversion factor, before geographic adjustment.

Surgical center rates: CMS ambulatory surgical center rates, Addendum AA (October 2026), effective October 1, 2026, read October 26, 2026.

Not shown: what Medicare pays a hospital outpatient department. CMS publishes those rates (October 2026 Addendum B) only behind the AMA CPT licence agreement, which this site has not accepted; last checked November 6, 2026.

NOTE 3: The Medicare program payment is 80 percent of the total payment amount and beneficiary coinsurance is 20 percent of the total payment amount except for most preventive services. Sections 4104 and 10406 of the Affordable Care Act (ACA) waive coinsurance and the Part B deductible for most preventive services. These preventive services are identified with a double asterisk (**). (CMS, Addendum AA, quoted as published.)

The patient’s share under Original Medicare

Original Medicare Part B has an annual deductible, paid once a year before Medicare starts to pay. It is $283 (Calendar year 2026). CMS: 2026 Medicare Parts A & B Premiums and Deductibles, read October 26, 2026.

After the Part B deductible, the patient usually pays 20% of the Medicare-approved amount for each covered service, where the provider accepts that amount as full payment. Medicare.gov: Medicare costs, read October 26, 2026.

Arithmetic, not a bill: 20% of the national surgical center rate for code 43235 ($497.85) is $99.57, before geographic adjustment and the deductible, and excluding the physician’s separate bill.

Medicare Advantage plans set their own cost-sharing; this site does not name or price any plan. Plan choice is explained on Medicare.gov.

Paying yourself: the Good Faith Estimate

Providers and facilities must give uninsured and self-pay patients a Good Faith Estimate of expected charges when a service is scheduled or on request.

“This section sets forth requirements for health care providers and health care facilities related to the issuance of good faith estimates of expected charges for uninsured (or self-pay) individuals (or their authorized representatives), upon request or upon scheduling an item or service.”

Ask for the estimate in writing when you book, and ask whether it covers the separate physician, radiology, anesthesia and pathology bills.

eCFR: 45 CFR 149.610, In force (45 CFR 149.610, text as of 2026-10-01), read October 26, 2026.

Calculator

Cash quote or insurance share for an Upper endoscopy?

Enter the quote you were given and your own plan figures. Every field starts empty: the tool uses only what you type, or a sourced figure you choose to copy in.

Arithmetic, not a bill
  • Median hospital cash price, code 43235 (US): $1,610.37 (55 hospitals, facility charge only). every hospital and its file, read October 26, 2026.
  • Median hospital negotiated rate, code 43235 (US): $1,557.80 (83 hospitals, facility charge only; your plan's own rate may differ). every hospital and its file, read October 26, 2026.

Enter a cash quote and your plan’s allowed amount to see the comparison.

The insurance share is the deductible still to pay (up to the allowed amount), plus your coinsurance on the rest, plus any copay, capped at the out-of-pocket limit you entered. It does not check network status, prior authorization, separately billed physician, radiology, anesthesia or pathology fees, or whether a cash payment counts toward your deductible.

Open shareable result

Help the dataset

A written quote or an explanation of benefits you have received helps other readers. Useful submissions include billing code, anesthesia fee, pathology fee, provider name, date quoted and whether the amount was a cash price, an allowed amount, your share on an explanation of benefits, or a billed charge.

Before booking, ask

Provider

  • What billing code will be used for this Upper endoscopy?
  • Is the cash quote complete, or are professional or facility fees separate?
  • Is contrast, anesthesia, pathology or follow-up included if relevant?
  • Can you provide the quote in writing before booking?
  • Is anesthesia included, and is the anesthesia provider in network?
  • Are biopsy and pathology fees included if samples are taken?
  • Which billing code will be used (diagnostic, biopsy or another step)?
  • Is anesthesia included in the quoted price and is the anesthesia provider in network?

Insurer

  • Is the provider in-network for my exact plan?
  • Will this billing code require prior authorization?
  • What patient responsibility do you estimate after deductible, copay and coinsurance?
  • If I pay cash, can I submit a claim afterwards, and would it count toward my deductible?

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Data funnel

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Upper endoscopy by state

46 of 51 states and DC have a hospital file we read with a figure for these codes.

What changes an Upper endoscopy bill?

The useful comparison is itemized. These are the fields to pin down before relying on any quote.

FactorWhy it mattersWhat to ask
Anesthesia billingAnesthesia is a separate bill from the gastroenterologist; its network status can differ.Ask whether anesthesia is included in the quote and whether the anesthesia provider is in network.
Pathology feesBiopsy samples generate a separate pathology bill.Ask whether pathology charges are bundled or billed separately.
Facility settingMedicare pays an ambulatory surgical center and a hospital outpatient department under different fee schedules.Confirm whether the procedure is at an ambulatory surgical center or a hospital outpatient department.
Diagnostic or with added stepsAdding a biopsy, dilation or bleeding control changes the code.Ask what else may be done during the same scope and how it would be billed.
Deductible and out-of-pocket limitHow much of your deductible is left decides how much of the allowed amount you pay yourself.Ask your insurer for your estimated patient responsibility, not just the negotiated rate.

Ambulatory surgical center (ASC)

A standalone outpatient surgery facility.

What to check: Anesthesia and pathology are still billed separately.

Hospital outpatient department

EGD performed at a hospital outpatient facility.

What to check: Hospital files list a facility charge separately from the physician.

Endoscopy clinic

A gastroenterology clinic offering scope-based procedures.

What to check: Check the anesthesia provider’s network status.

Common Upper endoscopy billing codes

The code changes the comparison. Ask the ordering clinician or provider which code will be billed. Labels are our own plain-English descriptions.

CodeWhat it isWhen it is used
43235EGD diagnosticReflux investigation, swallowing difficulty workup.
43239EGD with biopsyTissue sampling, for example for celiac disease or H. pylori.
43249EGD with dilationEsophageal narrowing.

Questions to ask before booking

  • Which billing code will be used (diagnostic, biopsy or another step)?
  • Is anesthesia included in the quoted price and is the anesthesia provider in network?
  • Are pathology fees included in the quote or billed separately?
  • Is the procedure at an ambulatory surgical center or a hospital outpatient department?
  • What is the facility charge, if any?
  • If I pay cash, will the payment count toward my deductible or out-of-pocket limit?
  • What is my estimated patient responsibility if billed to my insurance?

What these figures are not

  • A hospital’s discounted cash price is what that hospital charges a self-pay patient for the line it lists. It may not include the separately billed physician, radiologist, anesthesia or pathology fees.
  • A negotiated rate is what one payer contracted with one hospital. It is not what a patient on that plan pays, which depends on the deductible, coinsurance, copay and network status.
  • What Medicare pays is a national fee-schedule amount before geographic adjustment. It is not a price charged to anyone without Medicare.

Across 55 US hospital standard-charge files read between October 26, 2026 and November 6, 2026, the median discounted cash price for code 43235 (EGD diagnostic) was $1,610, as the hospital's facility charge. Each hospital's figure and file is listed on the TreatCompare page.

For the same code, the median of 83 hospitals' middle negotiated rates with insurers was $1,558. A negotiated rate is what the insurer pays the hospital, not what the patient pays.

Medicare's national payment amount for code 43235 is $497.85 (CMS ambulatory surgical center rates, Addendum AA (October 2026)), before geographic adjustment. It is not a price charged to anyone without Medicare.

Sources: hospital standard-charge files read between October 26, 2026 and November 6, 2026; CMS Physician Fee Schedule, relative value file RVU26D, read October 26, 2026.

Using this data?

Methodology, extracts and licensing

Updated November 6, 2026

Main sources

  • Hospital standard-charge files (109 hospitals, each file linked below)
  • CMS Physician Fee Schedule, relative value file RVU26D
  • CMS ambulatory surgical center rates, Addendum AA (October 2026)
  • CMS: 2026 Medicare Parts A & B Premiums and Deductibles
  • Medicare.gov: Medicare costs
  • HealthCare.gov glossary: out-of-pocket maximum/limit
  • eCFR: 45 CFR 149.610

Methodology: Hospital figures are read from each hospital's standard-charge file: one figure per hospital and billing code, facility charge only, with a median only at 4 or more hospitals, and cash and negotiated rates never combined. Medicare amounts are CMS's national fee-schedule amounts.

TreatCompare publishes healthcare, care-cost and treatment-pricing research for consumers, journalists, policymakers and commercial teams.

Contact TreatCompare about dataMethodology, source summaries and structured extracts: TreatCompare data team

Sources

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