Average Medicaid Upper Endoscopy (EGD) Payments in Lexington, KY: $300.49
Avg. Paid
$300.49
Range
$41.70 – $618.77
Total Claims
36,613
Providers
39
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 Lexington, KY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
George J Fuchs Iii
740 S Limestone |
$172.35 | 12 | 12 |
|
Damir Kusmic
160 N Eagle Creek Dr Ste 202 |
$67.60 | 15 | 12 |
|
Ruben Raphael Plentz
740 S Limestone Ste D201 |
$77.38 | 18 | 12 |
|
Joseph Auer
Chandler Medical Center 800 Rose St |
$145.66 | 26 | 26 |
|
Amy Coo Tiu
1401 Harrodsburg Rd |
$147.75 | 26 | 25 |
|
Ryan Jeffrey Beyer
740 S Limestone Uk Division Of Digestive Diseases |
$95.30 | 28 | 24 |
|
Thomas Charles Knopp
2620 Wilhite Dr |
$107.71 | 31 | 28 |
|
Donald Rauh
740 S Limestone Ste D201 |
$98.02 | 40 | 38 |
|
Donald Richberg Campbell
800 Rose St |
$86.17 | 50 | 46 |
|
Stephen Paul Schindler
2620 Wilhite Dr |
$92.60 | 62 | 56 |
|
Suzanna Attia
740 S Limestone St |
$99.69 | 65 | 51 |
|
Samuel Houssam Mardini
Uk Division Of Digestive Diseases |
$65.42 | 71 | 51 |
|
Earl Glen Robbins
3225 Summit Square Pl Ste 100 |
$41.70 | 77 | 60 |
|
Deborah R Flomenhoft
740 S Limestone St |
$100.00 | 90 | 79 |
|
Mariyam Hashmi
740 S Limestone Ste K201 |
$124.18 | 116 | 106 |
|
Rachel H Mathis
160 N Eagle Creek Dr Ste 201 |
$134.24 | 118 | 103 |
|
Joshua P. Steiner
1401 Harrodsburg Rd |
$131.44 | 153 | 130 |
|
Bahaaeldeen Senousy Mohammed Ismail
740 S Limestone |
$99.00 | 318 | 269 |
|
Bilal Aslam
1401 Harrodsburg Rd Ste C305 |
$89.60 | 327 | 294 |
|
James Stormer Pezzi
1780 Nicholasville Rd Ste 202 |
$104.88 | 377 | 309 |
|
Paige Nealy Quintero
2716 Old Rosebud Rd Ste 350 |
$132.93 | 415 | 366 |
|
Colorectal Surgical & Gastroenterology Associates Psc
2620 Wilhite Dr |
$240.52 | 487 | 408 |
|
Kathleen Martin
160 N Eagle Creek Dr |
$84.86 | 568 | 499 |
|
Sylvia Yirenkyi Ofei
800 Rose St |
$137.20 | 583 | 554 |
|
Victor Alex Howard
1720 Nicholasville Rd Ste 302 |
$94.63 | 615 | 538 |
|
New Lexington Clinic, Psc
1225 S Broadway |
$200.33 | 672 | 577 |
|
George Derek Weiss
2716 Old Rosebud Rd |
$124.42 | 695 | 589 |
|
Gregory M Woolfolk
1720 Nicholasville Rd Ste 302 |
$110.15 | 810 | 729 |
|
Troy Gibbons
138 Leader Ave Ofc 208 |
$137.28 | 829 | 767 |
|
Baptist Healthcare System, Inc
1740 Nicholasville Rd |
$392.11 | 929 | 663 |
|
Baptist Health Surgery Center Llc
3000 Baptist Health Blvd Ste 110 |
$203.70 | 1,075 | 802 |
|
Lexington Surgery Center Ltd
2115 Harrodsburg Rd |
$248.00 | 1,142 | 966 |
|
June Y Yong
1401 Harrodsburg Rd |
$89.34 | 1,663 | 1,453 |
|
Adalberto Roman Castellanos
1780 Nicholasville Rd Ste 202 |
$78.42 | 1,928 | 1,579 |
|
Saint Joseph Health System, Inc
1 Saint Joseph Dr |
$426.12 | 2,189 | 1,632 |
|
Saint Joseph Health System, Inc
150 N Eagle Creek Dr |
$331.35 | 2,901 | 2,223 |
|
Gregory Aaron Reynolds
341 Jane Briggs Ave |
$70.39 | 2,931 | 2,170 |
|
Baptist-Physicians Surgery Center
1720 Nicholasville Rd |
$255.05 | 5,543 | 4,865 |
|
University Of Kentucky
800 Rose St |
$618.77 | 8,618 | 7,873 |
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 Lexington, KY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Lexington, KY is $300.49 per claim, based on 36,613 claims from 39 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 Lexington, KY?
There are 39 Medicaid providers offering Upper Endoscopy (EGD) related services in Lexington, KY according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Lexington, KY?
Medicaid reimbursement for Upper Endoscopy (EGD) in Lexington, KY ranges from $41.70 to $618.77 per claim, with an average of $300.49. 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
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Avg $40.42
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