Average Medicaid Upper Endoscopy (EGD) Payments in Utica, NY: $458.50
Avg. Paid
$458.50
Range
$51.80 – $673.84
Total Claims
3,207
Providers
10
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 Utica, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Mvhs Inc
111 Hospital Dr |
$673.84 | 1,494 | 1,482 |
|
Mohawk Valley Ec, Llc
116 Business Park Dr |
$334.51 | 1,264 | 1,261 |
|
Mark M Pinkhasov
116 Business Park Drive |
$88.78 | 194 | 193 |
|
Robert Pavelock
116 Business Park Drive |
$83.81 | 85 | 85 |
|
Harvey Hamilton Allen
116 Business Park Drive |
$109.91 | 63 | 63 |
|
William A Graber
125 Business Park Dr Ste 150 |
$119.25 | 28 | 28 |
|
Bradley Sklar
116 Business Park Drive |
$69.18 | 26 | 25 |
|
Andrew T Pellecchia
1656 Champlin Ave |
$51.80 | 25 | 25 |
|
Natalie Anne Pavelock
116 Business Park Drive |
$110.29 | 16 | 15 |
|
Nandita Shiva Rao
1676 Sunset Ave |
$117.90 | 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 Utica, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Utica, NY is $458.50 per claim, based on 3,207 claims from 10 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 Utica, NY?
There are 10 Medicaid providers offering Upper Endoscopy (EGD) related services in Utica, NY according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Utica, NY?
Medicaid reimbursement for Upper Endoscopy (EGD) in Utica, NY ranges from $51.80 to $673.84 per claim, with an average of $458.50. 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 Utica, NY
Home Health Visit
Avg $146.48
1,418,271 claims
Blood Work & Lab Tests
Avg $8.00
866,904 claims
Office Visit
Avg $81.63
464,991 claims
Psychiatric Evaluation
Avg $105.72
272,745 claims
Case Management Services
Avg $314.51
242,895 claims
Emergency Room Visit
Avg $214.25
190,597 claims
Behavioral & Mental Health Therapy
Avg $80.73
172,741 claims
Urinalysis & Urine Tests
Avg $3.59
119,563 claims