Hvad Koster Øvre endoskopi (EGD)?
An upper endoscopy (esophagogastroduodenoscopy or EGD) is a procedure in which a thin, flexible scope is inserted through the mouth to examine the esophagus, stomach, and upper small intestine. It is used to diagnose conditions such as GERD, ulcers, celiac disease, and Barrett's esophagus.
Uden Forsikring
$3,000
Med Forsikring
$500
Medicare
$400
Nationalt Gennemsnit
$1,300
By Elena Bellini, MPH, Health Policy & Management · Last reviewed 2026-04-21 ·
Sources: CMS Medicare Provider Utilization and Payment Data 2025 · Methodology · Editorial standards Oversigt
An upper endoscopy — formally esophagogastroduodenoscopy (EGD) — uses a thin flexible scope passed through the mouth to evaluate the esophagus, stomach, and first portion of the small intestine. Gastroenterologists perform EGD to investigate reflux symptoms, difficulty swallowing, upper abdominal pain, unexplained anemia, chronic nausea, and suspected celiac disease or Barrett's esophagus. The procedure itself takes 10 to 20 minutes and is done under conscious sedation or monitored anesthesia; patients need a driver home. Biopsies are frequently taken, and small interventions — dilating a stricture, removing a polyp, banding varices, or clipping a bleed — can be performed during the same session, each of which adds a distinct CPT charge. Site of service has a major impact: an EGD at a hospital outpatient department can cost two to three times the same procedure at an ambulatory endoscopy center. Anesthesia staffing and pathology fees are separate line items.
Hvad påvirker prisen
- Site of service: ambulatory endoscopy centers typically bill 30-50% less than hospital outpatient departments for the same CPT codes.
- Sedation model: monitored anesthesia with propofol billed by a dedicated anesthesiologist costs more than gastroenterologist-administered conscious sedation.
- Interventions during the procedure: biopsies, dilation, polyp removal, hemostatic clips, or banding each add their own CPT charges on top of the diagnostic EGD.
- Pathology: tissue samples are sent to pathology and billed separately per specimen jar.
- In-network status: the anesthesiologist and pathologist may be contracted separately from the facility, creating possible out-of-network charges.
- Prior authorization: commercial plans often require it, and unauthorized studies can be denied, leaving patients with full chargemaster bills.
Sådan Sparer Du
- Ask your gastroenterologist whether an ambulatory endoscopy center is available instead of the hospital outpatient lab.
- Verify that prior authorization is on file with your commercial insurer before the scheduled date.
- Confirm the anesthesiologist and pathologist are in-network; the No Surprises Act offers protection but proactive checks are simpler.
- For self-pay patients, request a bundled Good Faith Estimate covering facility, gastroenterologist, anesthesia, and pathology.
- Ask whether conscious sedation is an option instead of MAC anesthesia to lower anesthesia charges.
- Reconcile every bill (facility, physician, anesthesia, pathology) against the EOB; coding mismatches are common and disputable.
Forsikrings- og dækningsoplysninger
Medicare Part B and commercial plans cover upper endoscopy when medically necessary for symptoms, surveillance of Barrett's esophagus, or follow-up of known disease. Commercial plans frequently require prior authorization; denial can follow if indications don't meet payer guidelines. Under Medicare, patients owe 20% coinsurance after the Part B deductible. Commercial cost-sharing commonly runs 10-30% and is subject to deductible. Unlike screening colonoscopy, a diagnostic EGD is not treated as a preventive service and cost-sharing applies from the first dollar after deductible. Expect separate bills from the gastroenterologist, facility, anesthesia group, and pathology lab.
Data sources for this page
Cost figures on this page are compiled from the following sources, triangulated per the rules in our methodology:
- CMS Medicare Provider Utilization and Payment Data 2025 — primary CMS reference used as the Medicare-rate anchor.
- Hospital Price Transparency machine-readable files (HPT MRFs) from a sample of major hospitals in each state, per the federal Hospital Price Transparency rule.
- Transparency in Coverage payer in-network rate files for commercial-rate cross-validation.
- State All-Payer Claims Database (APCD) summaries where published (Colorado, New Hampshire, Massachusetts, Minnesota, Maine, Utah, Vermont, Rhode Island, Washington, Oregon).
Last reviewed 2026-04-21. See editorial standards for our fact-checking process and correction policy.
Range: $2,190 to $4,140 · 50 states shown
Omkostning per Stat
| Stat | Uden Forsikring | Med Forsikring | Medicare |
|---|---|---|---|
| Mississippi | $2,190 | $365 | $292 |
| Arkansas | $2,250 | $375 | $300 |
| West Virginia | $2,250 | $375 | $300 |
| Alabama | $2,340 | $390 | $312 |
| Oklahoma | $2,340 | $390 | $312 |
| Kentucky | $2,550 | $425 | $340 |
| Louisiana | $2,580 | $430 | $344 |
| Iowa | $2,640 | $440 | $352 |
| New Mexico | $2,640 | $440 | $352 |
| South Carolina | $2,640 | $440 | $352 |
| South Dakota | $2,640 | $440 | $352 |
| Kansas | $2,670 | $445 | $356 |
| North Dakota | $2,670 | $445 | $356 |
| Idaho | $2,700 | $450 | $360 |
| Nebraska | $2,700 | $450 | $360 |
| Tennessee | $2,700 | $450 | $360 |
| Indiana | $2,790 | $465 | $372 |
| Missouri | $2,790 | $465 | $372 |
| Utah | $2,790 | $465 | $372 |
| Wyoming | $2,790 | $465 | $372 |
| Georgia | $2,820 | $470 | $376 |
| North Carolina | $2,820 | $470 | $376 |
| Michigan | $2,850 | $475 | $380 |
| Montana | $2,850 | $475 | $380 |
| Arizona | $2,940 | $490 | $392 |
| Ohio | $2,940 | $490 | $392 |
| Wisconsin | $2,940 | $490 | $392 |
| Maine | $2,970 | $495 | $396 |
| Texas | $2,970 | $495 | $396 |
| Florida | $3,030 | $505 | $404 |
| Minnesota | $3,030 | $505 | $404 |
| Illinois | $3,090 | $515 | $412 |
| Pennsylvania | $3,090 | $515 | $412 |
| Delaware | $3,120 | $520 | $416 |
| Nevada | $3,120 | $520 | $416 |
| Vermont | $3,120 | $520 | $416 |
| Virginia | $3,120 | $520 | $416 |
| Colorado | $3,180 | $530 | $424 |
| New Hampshire | $3,180 | $530 | $424 |
| Oregon | $3,180 | $530 | $424 |
| Maryland | $3,300 | $550 | $440 |
| Rhode Island | $3,330 | $555 | $444 |
| Washington | $3,330 | $555 | $444 |
| Connecticut | $3,600 | $600 | $480 |
| New Jersey | $3,600 | $600 | $480 |
| California | $3,930 | $655 | $524 |
| Massachusetts | $3,990 | $665 | $532 |
| Alaska | $4,050 | $675 | $540 |
| New York | $4,050 | $675 | $540 |
| Hawaii | $4,140 | $690 | $552 |
Ofte Stillede Spørgsmål
Hvad koster øvre endoskopi (egd) uden forsikring?
Den gennemsnitlige omkostning for øvre endoskopi (egd) uden forsikring i USA er $3,000. Omkostningerne varierer betydeligt per stat.
Dækker forsikringen øvre endoskopi (egd)?
De fleste sygeforsikringsplaner dækker øvre endoskopi (egd) når det er medicinsk nødvendigt. Med forsikring er den gennemsnitlige egenbetaling $500.
Dækker Medicare øvre endoskopi (egd)?
Medicare Del B dækker typisk øvre endoskopi (egd) efter lægeordination. Det gennemsnitlige Medicare-godkendte beløb er $400.
Gennemgået af Elena Bellini · Sidst gennemgået: 2026-04-21
Data fra CMS Medicare Provider Utilization and Payment Data 2025. Sidst opdateret: 2026-03-01. Denne information er kun til uddannelsesmæssige formål og udgør ikke medicinsk rådgivning. Denne hjemmeside er kun til informationsformål og udgør ikke medicinsk rådgivning. Kontakt altid en kvalificeret sundhedsperson.