Average Medicaid Upper Endoscopy (EGD) Payments in Raleigh, NC: $127.06
Avg. Paid
$127.06
Range
$45.73 – $212.41
Total Claims
1,665
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 Raleigh, NC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Triangle Gastroenterology Pllc
2600 Atlantic Ave |
$173.36 | 363 | 249 |
|
Wake Endoscopy Center, Llc
2601 Lake Dr |
$212.41 | 359 | 290 |
|
Karla Nicole Nieves Borrero
3521 Haworth Dr Fl 2 |
$45.73 | 278 | 222 |
|
Praneet Korrapati
2417 Atrirum Drive |
$111.96 | 174 | 150 |
|
Juan Gilberto Herrera
3024 New Bern Ave |
$66.03 | 92 | 82 |
|
Raleigh Nc Endoscopy Asc Llc
2417 Atrium Dr Ste 101 |
$79.20 | 79 | 50 |
|
Deepa Reddy
3024 New Bern Ave |
$72.04 | 66 | 61 |
|
Hirendra Navinchandr Doshi
2600 Atlantic Ave |
$59.90 | 52 | 37 |
|
Anil Prakash Tumbapura
2600 Atlantic Ave |
$65.06 | 51 | 37 |
|
Kerry N. Whitt
2601 Lake Dr |
$67.71 | 46 | 39 |
|
Rory Tynan Grace
4420 Lake Boone Trl |
$195.83 | 30 | 24 |
|
Bobby Mathew Jacob
4420 Lake Boone Trl |
$82.67 | 20 | 15 |
|
Riaz Sharif Mohammed Chowdhury
3024 New Bern Ave |
$72.37 | 15 | 15 |
|
Adeyemi Adekunle Lawal
3024 New Bern Ave |
$73.17 | 15 | 14 |
|
Brian S Dooreck
4420 Lake Boone Trl |
$209.00 | 13 | 12 |
|
Ashish Prabodh Shah
3024 New Bern Ave |
$92.15 | 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 Raleigh, NC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Raleigh, NC is $127.06 per claim, based on 1,665 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 Raleigh, NC?
There are 16 Medicaid providers offering Upper Endoscopy (EGD) related services in Raleigh, NC according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Raleigh, NC?
Medicaid reimbursement for Upper Endoscopy (EGD) in Raleigh, NC ranges from $45.73 to $212.41 per claim, with an average of $127.06. 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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