Average Medicaid Upper Endoscopy (EGD) Payments in Hialeah, FL: $77.59
Avg. Paid
$77.59
Range
$7.02 – $621.06
Total Claims
4,190
Providers
15
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 Hialeah, FL
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Luis Javier Victores
315 W 49Th St |
$65.12 | 919 | 783 |
|
The Palmetto Asc, Llc
2140 W 68Th St |
$57.19 | 606 | 446 |
|
Advanced Gastroenterology Of South Florida, P.A.
7100 W 20Th Ave |
$52.28 | 516 | 377 |
|
Juan Sarol
85 E 49Th St |
$35.93 | 502 | 410 |
|
Jose Luis Martinez
2140 W 68Th St |
$65.25 | 489 | 359 |
|
Gastrointestinal Center Of Hialeah, Llc
135 W 49Th St |
$201.23 | 477 | 396 |
|
Manuel Octavio Gonzalez
6050 W 20Th Ave Fl 3 |
$70.96 | 270 | 245 |
|
Digestive Diseases Services Of South Florida P A
777 E 25Th St |
$7.02 | 112 | 14 |
|
Sergio Max Rodriguez
777 E 25 St |
$64.17 | 73 | 66 |
|
Michael Andrew Cudworth
777 E 25Th St Ste 420 |
$68.06 | 62 | 53 |
|
Karthik Mohan
7100 W 20Th Ave |
$45.14 | 49 | 46 |
|
Onix Cesar Garib Alpizar
2140 W 68Th St Ste 300 |
$235.56 | 47 | 45 |
|
Joel Kertznus
2140 W 68Th St |
$157.78 | 42 | 39 |
|
Andrew Berry
7100 W 20Th Ave Ste 105 |
$621.06 | 14 | 12 |
|
Victor Manuel Padilla
2140 W 68Th St |
$19.45 | 12 | 12 |
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 Hialeah, FL?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Hialeah, FL is $77.59 per claim, based on 4,190 claims from 15 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 Hialeah, FL?
There are 15 Medicaid providers offering Upper Endoscopy (EGD) related services in Hialeah, FL according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Hialeah, FL?
Medicaid reimbursement for Upper Endoscopy (EGD) in Hialeah, FL ranges from $7.02 to $621.06 per claim, with an average of $77.59. 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
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Phoenix, AZ
Avg $302.49
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Bakersfield, CA
Avg $392.48
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Los Angeles, CA
Avg $140.58
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Tucson, AZ
Avg $288.42
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Detroit, MI
Avg $206.86
50,758 claims · 16 providers
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