Average Medicaid Upper Endoscopy (EGD) Payments in Detroit, MI: $206.86
Avg. Paid
$206.86
Range
$61.65 – $385.78
Total Claims
50,758
Providers
16
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 Detroit, MI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
S Madani Md Pc
4727 Saint Antoine St |
$72.96 | 13 | 13 |
|
Brian Rutledge
4201 Saint Antoine St Ste 5C |
$78.54 | 70 | 66 |
|
Vhs Detroit Receiving Hospital Inc
4201 Saint Antoine St |
$361.30 | 174 | 173 |
|
Tariq Abdelrahim Faris Hammad
2799 W Grand Blvd # K-7 |
$88.93 | 212 | 196 |
|
Kartheek B Nagappala
4201 Saint Antoine St |
$72.41 | 313 | 309 |
|
Ascension St John Hospital
22101 Moross Rd |
$73.31 | 442 | 439 |
|
Plexus Gastro Pllc
6501 Greenfield Rd |
$67.54 | 445 | 444 |
|
Ravish Manojkumar Parekh
2799 W Grand Blvd |
$210.82 | 775 | 727 |
|
Hussein Al-Hamid
22201 Moross Rd |
$75.77 | 1,196 | 1,107 |
|
University Pediatricians
3901 Beaubien |
$69.84 | 3,491 | 3,437 |
|
Vhs Childrens Hospital Of Michigan Inc
3901 Beaubien St |
$385.78 | 4,035 | 4,013 |
|
Vhs Sinai-Grace Hospital Inc
6071 W Outer Dr |
$352.33 | 5,448 | 5,407 |
|
Vhs Harper-Hutzel Hospital Inc
3990 John R St |
$362.36 | 6,464 | 6,382 |
|
University Physician Group
4201 St. Antoine St. |
$61.77 | 6,474 | 6,267 |
|
Henry Ford Health System
2799 W Grand Blvd |
$322.46 | 8,831 | 8,764 |
|
Henry Ford Health System
2799 W Grand Blvd |
$61.65 | 12,375 | 12,120 |
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 Detroit, MI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Detroit, MI is $206.86 per claim, based on 50,758 claims from 16 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 Detroit, MI?
There are 16 Medicaid providers offering Upper Endoscopy (EGD) related services in Detroit, MI according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Detroit, MI?
Medicaid reimbursement for Upper Endoscopy (EGD) in Detroit, MI ranges from $61.65 to $385.78 per claim, with an average of $206.86. 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
Milwaukee, WI
Avg $194.85
46,905 claims · 54 providers
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4,694,783 claims
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