Average Medicaid Upper Endoscopy (EGD) Payments in Bayamon, PR: $307.47
Avg. Paid
$307.47
Range
$55.39 – $398.29
Total Claims
6,539
Providers
14
Typical Payment Range
Typical Medicaid Upper Endoscopy (EGD) payments fall between $76.12 and $225.09 per claim (median: $127.97). The top 10% of payments exceed $381.16.
Based on per-provider averages across all Medicaid claims in this category.
Upper endoscopy examines the lining of the esophagus, stomach, and first part of the small intestine using a thin, flexible tube with a camera.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Upper Endoscopy (EGD) in Bayamon, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Carlos J Estrada
70 Calle Santa Cruz |
$108.03 | 16 | 13 |
|
Adalberto Lopez Aviles
Calle Santa Cruz #70 |
$55.39 | 17 | 14 |
|
Wilma L Cotto Oyola
Calle Santa Cruz, Edif. Medico Santa Cruz #73 |
$377.07 | 29 | 29 |
|
Veronica Beyley-Pagan
Calle J #13 Esq Calle B3 |
$377.63 | 74 | 53 |
|
Rafael Solis-Mounier
Bayamon Medical Plz |
$398.29 | 151 | 99 |
|
Mario Javier Vazquez Cruz
Calle Sta. Cruz #70 Urb. Sta. Cruz |
$86.41 | 171 | 143 |
|
Ignacio Javier Jaca Montijo
Metro Medical Center Suite 903B |
$308.41 | 233 | 220 |
|
Carlos A Latimer
Edif Cadilla |
$308.07 | 267 | 255 |
|
Jorge L Cortes-Ruiz
Instituto San Pablo |
$365.45 | 537 | 358 |
|
Ekie G Vazquez-Maldonado
Urb. Rexville |
$366.56 | 650 | 623 |
|
Irma M. Vargas-Ramos
Carr # 2 Km. 11.7 |
$107.30 | 652 | 469 |
|
Octavio Jordan Lopez
Edif Medico Santa Cruz |
$257.51 | 890 | 764 |
|
Santiago Coste-Sibilia
Metro Medical Center |
$337.20 | 1,085 | 772 |
|
Roberto Enrique Osorio Manotas
Paseo San Pablo #100 Edif Arturo Cadilla Suite 501 |
$362.44 | 1,767 | 1,462 |
What to Expect: Upper Endoscopy (EGD)
An upper endoscopy takes 15-30 minutes. You'll be sedated. A thin flexible tube with a camera is passed through your mouth into your esophagus, stomach, and duodenum. Biopsies may be taken. You'll need someone to drive you home afterward. Most people can eat a few hours after the procedure. Mild throat soreness is common for a day or two.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 43239 | EGD w/biopsy upper GI | $253.86 | 5,956,836 | 9,455 |
| 43235 | EGD diagnostic upper GI | $254.50 | 202,728 | 958 |
| 43248 | EGD w/dilation guide wire | $140.00 | 59,963 | 186 |
| 43249 | EGD w/balloon dilation | $350.47 | 27,932 | 155 |
| 43251 | EGD w/snare removal | $247.77 | 8,994 | 30 |
| 43255 | EGD w/control bleeding | $475.08 | 7,407 | 9 |
| 43246 | EGD w/PEG tube placement | $137.82 | 3,019 | 30 |
| 43237 | EGD w/endoscopic us | $308.70 | 2,887 | 33 |
| 43250 | EGD w/tumor removal | $258.39 | 2,380 | 11 |
| 43244 | EGD w/band ligation | $253.62 | 1,697 | 25 |
| 43236 | EGD w/submucosal injection | $37.02 | 1,037 | 6 |
| 43245 | EGD w/dilation stricture | $91.88 | 1,020 | 10 |
| 43247 | EGD w/foreign body removal | $93.65 | 915 | 11 |
| 43252 | EGD w/optical endomicroscopy | $166.89 | 722 | 10 |
| 43254 | EGD w/endo mucosal resection | $164.97 | 472 | 2 |
| 43242 | EGD w/us guided inj/asp | $234.58 | 258 | 9 |
| 43253 | EGD w/injection sclerosis | $179.99 | 161 | 4 |
| 43238 | EGD w/us guided needle bx | $618.60 | 13 | 1 |
| 43241 | EGD w/tube/catheter | $91.14 | 13 | 1 |
| 43240 | EGD w/drainage pseudocyst | — | — | — |
| 43243 | EGD w/injection varices | — | — | — |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Upper Endoscopy (EGD) cost in Bayamon, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Bayamon, PR is $307.47 per claim, based on 6,539 claims from 14 providers. Typical payments fall between $76.12 and $225.09. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Upper Endoscopy (EGD) in Bayamon, PR?
There are 14 Medicaid providers offering Upper Endoscopy (EGD) related services in Bayamon, PR according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Bayamon, PR?
Medicaid reimbursement for Upper Endoscopy (EGD) in Bayamon, PR ranges from $55.39 to $398.29 per claim, with an average of $307.47. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Upper Endoscopy (EGD) in Other Cities
Brooklyn, NY
Avg $322.26
138,581 claims · 113 providers
New York, NY
Avg $375.46
133,047 claims · 106 providers
Flushing, NY
Avg $306.22
93,103 claims · 35 providers
Phoenix, AZ
Avg $302.49
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Bakersfield, CA
Avg $392.48
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Los Angeles, CA
Avg $140.58
60,228 claims · 72 providers
Tucson, AZ
Avg $288.42
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Detroit, MI
Avg $206.86
50,758 claims · 16 providers
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