Average Medicaid Upper Endoscopy (EGD) Payments in San Juan, PR: $289.60
Avg. Paid
$289.60
Range
$51.22 – $367.31
Total Claims
12,587
Providers
31
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 San Juan, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Eladio Perez Cruz
1449 Calle Americo Salas |
$316.27 | 2,733 | 2,616 |
|
Jose M Vega-Martinez
University District Hospital |
$306.70 | 1,869 | 1,737 |
|
Instituto De Gastroenterologia De P.R.
400 Ave F.D. Roosevelt Ave. |
$280.35 | 1,376 | 1,357 |
|
Myriam Villafana-Suarez
400 Ave Fd Roosevelt |
$328.44 | 1,257 | 1,170 |
|
Carlos Laboy-Olivieri
8050 Cond San Juan Chalets |
$232.23 | 1,019 | 975 |
|
Reinaldo Ramirez Amill
Centro Medico |
$367.31 | 815 | 761 |
|
Rafael Cordero-Arill
University Of Puerto Rico Medical Sciences Campus |
$225.36 | 617 | 585 |
|
Luis Vargas Bird
275 Calle Jilguero |
$95.52 | 591 | 466 |
|
Walisbeth Class-Vazquez
239 Arterial Hostos Ave |
$305.13 | 500 | 424 |
|
Fernando Ramos-Mercado
400 Ave Fd Roosevelt |
$329.40 | 429 | 410 |
|
Carlos J Fernandez-Cruz
1801 Ave Ponce De Leon Ste 409-410 |
$327.24 | 350 | 321 |
|
Pablo J Costas
1056 Ave Munoz Rivera |
$277.00 | 162 | 159 |
|
Fernando J Bonilla-Valentin
10 Calle Casia |
$356.27 | 158 | 150 |
|
Rodolfo Estremera-Marcial
1801 Santurce Medical Mall |
$329.33 | 143 | 141 |
|
Allan Santiago
29 Calle Washington Ste 705 |
$317.70 | 97 | 87 |
|
Vasco Eguia Moreda
1607 Ave Ponce De Leon Ste Gm04 |
$333.35 | 66 | 56 |
|
Javier Antonio Cerra-Franco
Centro Comprensivo De Cancer De Puerto Rico |
$282.93 | 54 | 49 |
|
Lymari Vargas-Rivera
550 Calle Sergio Cuevas |
$70.78 | 51 | 30 |
|
Miguel A. Marrero - Rivera
Anesthesiology Department Suite 983 |
$98.27 | 50 | 24 |
|
Julia Haydee Maldonado-Alejandro
Anestesia Rcm |
$104.85 | 34 | 34 |
|
Ian Carlos Padial Doble
University District Hospital |
$202.50 | 28 | 28 |
|
Hamid Galib
1801 Ave Ponce De Leon |
$77.89 | 27 | 27 |
|
San Jorge Associates
258 Calle San Jorge |
$100.96 | 26 | 25 |
|
Hato Rey Medical Gastro,Csp
735 Ave Ponce De Leon Ste 809 |
$274.41 | 25 | 25 |
|
Lmv Gastroenterology Psc
1449 Calle Americo Salas Ste 103 |
$290.00 | 24 | 24 |
|
Victor Luis Carlo
Torre Medica Auxilio Mutuo Suite 816 |
$224.28 | 17 | 16 |
|
Henry Gonzalez-Rivera
200 Ave W Churchill |
$199.51 | 16 | 14 |
|
Recinto De Ciencias Medicas
Centro Medico De Pr Edif Principal |
$288.07 | 15 | 12 |
|
Rosalyn Diaz
684 Calle Merida |
$245.38 | 13 | 13 |
|
Benjamin Muniz Roldos
150 Ave De Diego |
$100.00 | 13 | 13 |
|
Denise Baez Garcia
Medical Center Udh Adult 2 Hipaa Office |
$51.22 | 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 San Juan, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in San Juan, PR is $289.60 per claim, based on 12,587 claims from 31 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 San Juan, PR?
There are 31 Medicaid providers offering Upper Endoscopy (EGD) related services in San Juan, PR according to public payment data.
What is the price range for Upper Endoscopy (EGD) in San Juan, PR?
Medicaid reimbursement for Upper Endoscopy (EGD) in San Juan, PR ranges from $51.22 to $367.31 per claim, with an average of $289.60. 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 $18.99
3,140,039 claims
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Avg $9.31
1,652,042 claims
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Avg $77.12
603,331 claims
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Avg $20.92
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X-Ray
Avg $9.69
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Avg $66.54
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Avg $3.33
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Avg $38.11
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