Average Medicaid Upper Endoscopy (EGD) Payments in Cincinnati, OH: $270.58
Avg. Paid
$270.58
Range
$53.21 – $467.67
Total Claims
24,007
Providers
63
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 Cincinnati, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Cincinnati Asc Llc
9275 Montgomery Rd |
$284.72 | 12 | 12 |
|
Terrance Michael O'Toole
2925 Vernon Pl |
$118.36 | 12 | 12 |
|
Melanie Green
10600 Montgomery Rd |
$99.07 | 12 | 12 |
|
Scott P Pentiuk
3333 Burnet Avenue |
$134.78 | 13 | 12 |
|
Marvin J Lopez
7661 Beechmont Ave Ste 120 |
$102.40 | 13 | 12 |
|
Bella Zeisler
3333 Burnet Avenue |
$77.18 | 13 | 13 |
|
Mark A Manegold
3219 Clifton Ave Ste 330 |
$75.86 | 13 | 12 |
|
Journey Lite Of Cincinnati, Llc
10475 Reading Road |
$303.33 | 14 | 13 |
|
Manish M. Chokshi
2925 Vernon Pl |
$83.53 | 14 | 12 |
|
Michel Ghastine
10600 Montgomery Rd |
$77.89 | 14 | 12 |
|
Amit Gajera
2925 Vernon Pl |
$71.05 | 15 | 13 |
|
Michelle Saad
3333 Burnet Ave |
$96.87 | 16 | 13 |
|
Kai Yik Ha
2925 Vernon Pl Ste 100 |
$78.07 | 16 | 13 |
|
Neha Santucci
3333 Burnet Ave # Mlc2010 |
$77.81 | 18 | 13 |
|
Temara Mahmood Mohammad Hajjat
3333 Burnet Ave |
$126.17 | 25 | 25 |
|
Terry R Kaylor
2925 Vernon Pl |
$111.68 | 26 | 26 |
|
Neha Wadhwa
222 Piedmont Ave |
$101.20 | 26 | 24 |
|
Nadav Sahar
3219 Clifton Ave |
$94.11 | 28 | 25 |
|
David Nathaniel Fitch
425 Farrell Ct |
$82.71 | 28 | 25 |
|
David D Hess
6949 Good Samaritan Dr |
$263.21 | 29 | 27 |
|
Ravi V. Ravinuthala
2925 Vernon Pl |
$70.35 | 29 | 26 |
|
Loren Phillip Brook
234 Goodman St |
$92.94 | 31 | 29 |
|
Kevin Michael Cronley
2925 Vernon Pl |
$95.66 | 34 | 27 |
|
Moamen Gabr
222 Piedmont Ave |
$53.21 | 40 | 26 |
|
Krishnamurthi Ramprasad
222 Piedmont Ave |
$76.41 | 41 | 38 |
|
Aditi Mulgund Stanton
3301 Mercy Health Blvd Ste 445 |
$69.22 | 44 | 38 |
|
Vincent A Mukkada
3333 Burnet Ave |
$148.98 | 46 | 44 |
|
Jose' Garza
3333 Burnet Ave |
$119.39 | 48 | 40 |
|
Jeffrey D. Stotz
2925 Vernon Pl |
$89.15 | 51 | 43 |
|
Joshua B Max
10600 Montgomery Rd |
$82.55 | 51 | 48 |
|
Jorge Tan Go
2925 Vernon Pl Ste 100 |
$95.12 | 51 | 50 |
|
Emmanuel A. Ofori
7502 State Rd Ste 1180 |
$86.98 | 66 | 57 |
|
Matthew Atkinson
2925 Vernon Pl |
$65.90 | 91 | 80 |
|
Muhammad-Hani Fadhl Dawwas
222 Piedmont Ave |
$82.47 | 94 | 82 |
|
Soohwan Chun
6949 Good Samaritan Dr Ste 230 |
$87.61 | 140 | 132 |
|
Ranjith Wijeratne
3219 Clifton Ave |
$126.29 | 158 | 152 |
|
Manojkumar S Singh
8231 Cornell Rd Ste 320 |
$86.53 | 188 | 171 |
|
Steven Richard Gay
3130 Highland Ave |
$96.98 | 190 | 172 |
|
James Robert Rick
3333 Burnet Ave |
$137.49 | 247 | 227 |
|
Venkata Muddana
3219 Clifton Ave |
$178.43 | 276 | 248 |
|
Abhishek Datta Polavarapu
3188 Bellevue Ave |
$63.78 | 313 | 308 |
|
Mercy Health - Anderson Hospital Llc
7500 State Rd |
$347.65 | 319 | 260 |
|
Piush Gupta
6949 Good Samaritan Dr |
$145.98 | 330 | 318 |
|
Rajagopal Chadalavada
10600 Montgomery Rd Ste 200 |
$96.61 | 369 | 333 |
|
Ajay Kaul
3333 Burnet Ave |
$131.58 | 388 | 353 |
|
Christ Hospital
2139 Auburn Ave |
$346.07 | 460 | 394 |
|
Gregory Mathias Lam
7661 Beechmont Ave Ste 120 |
$103.42 | 485 | 440 |
|
Mercy Health - West Hospital Llc
3300 Mercy Health Blvd |
$333.09 | 551 | 431 |
|
Kara Mari De Felice
222 Piedmont Ave |
$165.92 | 557 | 421 |
|
Ligia Maria Alfaro Cruz
3333 Burnet Ave |
$234.70 | 574 | 470 |
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 Cincinnati, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Cincinnati, OH is $270.58 per claim, based on 24,007 claims from 63 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 Cincinnati, OH?
There are 63 Medicaid providers offering Upper Endoscopy (EGD) related services in Cincinnati, OH according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Cincinnati, OH?
Medicaid reimbursement for Upper Endoscopy (EGD) in Cincinnati, OH ranges from $53.21 to $467.67 per claim, with an average of $270.58. 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
71,548 claims · 71 providers
Bakersfield, CA
Avg $392.48
66,129 claims · 26 providers
Los Angeles, CA
Avg $140.58
60,228 claims · 72 providers
Tucson, AZ
Avg $288.42
55,967 claims · 58 providers
Detroit, MI
Avg $206.86
50,758 claims · 16 providers
Other Procedures in Cincinnati, OH
Blood Work & Lab Tests
Avg $7.16
12,933,390 claims
Office Visit
Avg $57.26
6,244,164 claims
Emergency Room Visit
Avg $94.36
2,312,527 claims
Home Health Visit
Avg $67.23
2,297,701 claims
Behavioral & Mental Health Therapy
Avg $87.07
2,275,452 claims
Substance Abuse Treatment
Avg $55.29
2,244,339 claims
Psychiatric Evaluation
Avg $79.56
1,780,978 claims
Urinalysis & Urine Tests
Avg $2.81
1,707,210 claims