Always confirm costs with your healthcare facility and/or insurance coverage
If you’ve been told you need an endoscopy—whether it’s to investigate acid reflux, ulcers, or unexplained stomach pain—your next question is probably: how much is this going to cost?
The answer depends on a number of factors: type of endoscopy, sedation used, location, and insurance coverage. In 2025, medical costs are still unpredictable, but here’s a clear breakdown of what you can expect.
Average Endoscopy Costs in 2025
Type of Endoscopy |
Average Cost (Without Insurance) |
|---|---|
Upper Endoscopy (EGD) |
$1,200 – $3,500 |
Colonoscopy |
$1,000 – $3,800 |
Sigmoidoscopy |
$800 – $2,000 |
Capsule Endoscopy |
$1,500 – $4,000 |
Endoscopic Ultrasound (EUS) |
$2,500 – $7,000 |
🚫 These prices include facility fees, sedation, physician fees, and pathology labs, but complications, biopsies, or anesthesia upgrades can increase costs.
Cost With Insurance 📄
Insurance Type |
Estimated Out-of-Pocket Cost |
|---|---|
Private (Employer Plan) |
$200 – $1,500 |
ACA Marketplace (Silver) |
$800 – $2,000 |
~$200 – $500 (Part B, 20% coinsurance) |
|
Medicaid |
Often free or very low-cost if approved |
🔹 If the endoscopy is screening-based (e.g., colonoscopy for age 45+), it may be 100% covered under preventive care guidelines.
Factors That Affect Endoscopy Costs 💳
1. Type of Endoscopy
- A standard upper endoscopy (EGD) is cheaper than specialized procedures like EUS or capsule endoscopy.
2. Sedation Type
- Conscious sedation (moderate) is cheaper.
- General anesthesia adds $500–$1,000 to your bill.
3. Facility Location
- Outpatient centers or GI clinics are cheaper than hospitals.
- Hospital-based procedures may cost 2–3x more.
4. Insurance Coverage & Network
- In-network providers and facilities = lower costs.
- Pre-authorization is often required.
5. Additional Services
- Biopsies, pathology analysis, polyp removal, and follow-up visits add to your total.
Cost Breakdown 💰
Component |
Typical Cost |
|---|---|
Facility Fee |
$500 – $2,000 |
Physician Fee |
$300 – $900 |
Sedation/Anesthesia |
$250 – $1,200 |
Pathology (Biopsies) |
$100 – $700 |
Tips to Save Money on Your Endoscopy 🎁
✅ Ask for a cash-pay discount
- Many outpatient clinics offer flat-rate pricing for uninsured patients.
✅ Compare facilities
- GI clinics often cost 50% less than hospitals.
✅ Verify in-network status
- Double check that facility, GI doctor, anesthesiologist, and lab are all in-network.
✅ Request an itemized quote
- Ask for a CPT code estimate and get a cost breakdown before the procedure.
When Is an Endoscopy Covered as Preventive Care? 🚀
Some endoscopies—particularly colonoscopy screenings at age 45+—are fully covered under most ACA-compliant plans.
✔ No cost-sharing if it’s a scheduled screening (no symptoms present) ✔ If polyps are removed, it may still be fully covered (check your policy) 🚫 Diagnostic procedures (due to symptoms) typically trigger normal deductibles and coinsurance.
Final Thoughts 🤔
In 2025, an endoscopy can cost anywhere from $1,200 to $4,000 out-of-pocket without insurance—and $200 to $2,000 with it, depending on your plan. If you’re due for a routine check or managing a GI condition, it’s worth shopping around and verifying every cost component before the procedure.
Had an endoscopy lately? Drop your cost or tips in the comments to help others navigate it! 💬
🧾 User-Reported Cost: It’s wild how many folks think endoscopy costs won’t hit their wallets hard, just because of insurance. Seriously, be ready for those surprise fees, especially if you go to a hospital instead of a cheaper outpatient center. It really feels like they’re just after your hard-earned cash, doesn’t it?
🧾 User-Reported Cost: And those surprise fees are like uninvited guests. think lab tests and follow-ups that just keep adding to the bill. Why not try to negotiate like you’re at a flea market?
🧾 User-Reported Cost: That is completely off. Most pre-insurance cost in Kentucky is around 9-14k, after 3k-6k. Not sure where you are getting your info but all you have to do is call the billing departments in the area and give them the CPT code 43235 (plain endoscopy, no biopsy which would be more). They are required to tell you the cost.
🧾 User-Reported Cost: Thanks for your comment — you’re absolutely right that costs can vary significantly by region, and Kentucky in particular tends to run higher than the national average. Our listed ranges for CPT 43235 are based on aggregated national billing data from public sources and claims data, not just one geographic area.
You’re also correct that calling local billing departments directly with the CPT code will usually get you the most accurate local rate — and we actually encourage that in many of our posts. If you’re seeing $9–14K before insurance in your area, we’d love to hear more and potentially include that as a regional example in our upcoming data updates.
Appreciate you keeping us honest — that’s literally the whole point of CostHowMuch. (not everyone will call billing depts – in fact, I’d love a statistic that shows this action…)