Average Medicaid Upper Endoscopy (EGD) Payments in Providence, RI: $167.07
Avg. Paid
$167.07
Range
$99.83 – $526.14
Total Claims
2,892
Providers
26
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 Providence, RI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Valley C Dreisbach
44 W River St |
$187.54 | 12 | 12 |
|
Marcoandrea Giorgi
195 Collyer St Ste 302 |
$265.16 | 12 | 12 |
|
Tian Gao
44 W River St |
$99.83 | 12 | 12 |
|
Rhode Island Hospital
593 Eddy St |
$200.55 | 14 | 14 |
|
David Schreiber
44 W River St |
$237.04 | 14 | 13 |
|
Mariam Fayek
101 Dudley Street |
$188.19 | 14 | 14 |
|
Irina Gorbounova
593 Eddy St |
$459.75 | 15 | 15 |
|
Vania Kasper
593 Eddy St |
$336.72 | 16 | 15 |
|
Shannon Simmons
593 Eddy St |
$265.51 | 17 | 17 |
|
Daniel Greenwald
44 W River St |
$163.41 | 24 | 24 |
|
Nnenna Chinyere Okpara
101 Dudley St |
$214.97 | 25 | 25 |
|
Diana Ying Wu
100 Dudley St |
$526.14 | 26 | 26 |
|
Peter Scott Margolis
33 Staniford St |
$155.08 | 33 | 30 |
|
Michael I Herzlinger
593 Eddy St |
$445.37 | 40 | 40 |
|
Breton Roussel
33 Staniford Street |
$142.96 | 41 | 40 |
|
William T. Chen
33 Staniford Street |
$163.91 | 46 | 41 |
|
Kevin S. Palumbo
33 Staniford St |
$114.64 | 55 | 50 |
|
Amanda B Pressman
146 West River Street |
$297.69 | 72 | 71 |
|
Archana Lingannan
593 Eddy St |
$195.72 | 82 | 82 |
|
Paul A. Akerman
33 Staniford St |
$125.55 | 88 | 74 |
|
Thaer Saqer Mustafa Abdelfattah
50 Maude St |
$155.31 | 104 | 101 |
|
Eric B. Newton
33 Staniford St |
$133.89 | 154 | 137 |
|
Nabil Anis Toubia
50 Maude St |
$168.12 | 188 | 174 |
|
Philip Mcandrew
148 W River St |
$144.51 | 441 | 411 |
|
Jeffrey Nadelson
33 Staniford St Fl 1 |
$162.56 | 521 | 492 |
|
Jason Ferreira
148 W River St Ste 3 |
$145.32 | 826 | 788 |
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 Providence, RI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Providence, RI is $167.07 per claim, based on 2,892 claims from 26 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 Providence, RI?
There are 26 Medicaid providers offering Upper Endoscopy (EGD) related services in Providence, RI according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Providence, RI?
Medicaid reimbursement for Upper Endoscopy (EGD) in Providence, RI ranges from $99.83 to $526.14 per claim, with an average of $167.07. 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 Providence, RI
Personal Care Services
Avg $125.03
2,057,051 claims
Office Visit
Avg $73.05
1,843,254 claims
Emergency Room Visit
Avg $92.98
754,000 claims
Behavioral & Mental Health Therapy
Avg $129.47
740,415 claims
Dental Cleaning & Exam
Avg $30.60
677,431 claims
Case Management Services
Avg $18.33
599,589 claims
Psychiatric Evaluation
Avg $71.24
531,502 claims
Substance Abuse Treatment
Avg $47.48
496,940 claims