Average Medicaid Upper Endoscopy (EGD) Payments in Santa Rosa, CA: $119.82
Avg. Paid
$119.82
Range
$44.10 – $307.14
Total Claims
3,958
Providers
11
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 Santa Rosa, CA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
St. Joseph Health Northern California, Llc
1165 Montgomery Dr |
$44.10 | 1,820 | 1,774 |
|
Sutter Bay Hospitals
30 Mark West Springs Road |
$112.67 | 543 | 539 |
|
Razi M Arifuddin
500 Doyle Park Dr |
$238.63 | 533 | 526 |
|
Frances Hungyi Lu
500 Doyle Park Dr Ste 205 |
$271.26 | 334 | 321 |
|
Santa Rosa Surgery Center L P
34 Mark West Springs Rd Suite 100 |
$45.40 | 305 | 303 |
|
Joshua P Beirne
500 Doyle Park Dr |
$257.00 | 143 | 141 |
|
Sumit Kohli
34 Mark West Springs Rd Fl 2 |
$199.07 | 95 | 92 |
|
Alexander Michael Lustberg
500 Doyle Park Dr |
$205.63 | 85 | 85 |
|
Frank L Anderson
34 Mark West Springs Rd Fl 2 |
$272.74 | 75 | 75 |
|
Robert Logan Faust
1210 Sonoma Ave |
$307.14 | 13 | 13 |
|
Runalia Bahar
34 Mark West Springs Rd |
$298.86 | 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 Santa Rosa, CA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Santa Rosa, CA is $119.82 per claim, based on 3,958 claims from 11 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 Santa Rosa, CA?
There are 11 Medicaid providers offering Upper Endoscopy (EGD) related services in Santa Rosa, CA according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Santa Rosa, CA?
Medicaid reimbursement for Upper Endoscopy (EGD) in Santa Rosa, CA ranges from $44.10 to $307.14 per claim, with an average of $119.82. 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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