 | With Health Insurance: Copay + 10%-50% of Procedure Cost |
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 | Without Health Insurance: $1,500-$10,000+ |
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| Upper gastrointestinal endoscopy (also known as gastroscopy, or as EGD, which is short for esophagogastroduodenoscopy) involves the use of a flexible tube with an attached camera and light to examine the inside of the upper digestive tract, often to further investigate pain or digestive problems. (A lower GI endoscopy, more commonly known as a colonoscopy, examines the lower GI tract.) Complications are rare, but risks include reaction to the sedative, excessive bleeding and perforation of the esophagus or stomach. | | |
| Typical costs: | - For patients covered by health insurance, out-of-pocket costs typically include an office visit copay and coinsurance of 10% to 50% for the procedure. Depending on the insurance, the cost could reach $1,000 or more. For example, at Darmouth-Hitchcock Medical Center in New Hampshire, a patient with Medicare would pay $1,447 without supplemental insurance. Gastrointestinal endoscopy typically is covered by health insurance when considered medically necessary. For example, Aetna considers it medically necessary for diagnosis in a variety of situations, including for evaluation of certain upper abdominal symptoms, of persistent unexplained vomiting, of GI bleeding, and to investigate masses.
- For patients not covered by health insurance, upper gastrointestinal endoscopy typically costs between about $1,500 -$10,000 or more, depending on the provider, geographic location, whether sedation is used or not and whether the procedure is done in an imaging center or in a hospital. The national average cost is $2,700 -- but prices can range from $1,350 to $10,400, according to NewChoiceHealth.com. At the Dartmouth-Hitchcock Medical Center in New Hampshire, a patient without insurance coverage would pay $3,396. At Baptist Memorial Health Care in Memphis, the cost would be about $3,512.
What should be included: | - In an upper gastrointestinal endoscopy, which is typically performed on an outpatient basis, the patient will be given an anesthetic for the throat and sedated using an IV. Then, the doctor will push the endoscope down the throat and into the esophagus and stomach. The images of the inside of the upper GI tract will be displayed on a large screen during the procedure, and the doctor can take a tissue sample for biopsy or remove a polyp, if necessary, during the half-hour procedure.
- The patient can go home after sedation wears off, in about an hour, but should take the rest of the day off work. No driving is permitted for up to 24 hours.
- The National Institutes of Health has an overview of upper gastrointestinal endoscopy.
Additional costs: | - If it is necessary to take a biopsy, that would add a procedure cost and laboratory cost to the final bill. This could add as much as several thousand dollars to the cost. For example, at Good Samaritan Hospital in California, a biopsy adds $1,100 -$4,800.
Discounts: | - Some free or low-cost clinics, such as the NYC Free Clinic and the Clinic at Brackenridge in Austin, TX, offer access to specialist care. The U.S. Department of Health & Human Services has a tool to find a federally funded health clinic. If a nearby clinic does not offer the procedure, they can provide a referral.
Shopping for an egd: | - A physician with extensive training and experience performing gastrointestinal endoscopy should conduct the procedure. The American Society for Gastrointestinal Endoscopy offers a doctor locator.
- The ASGE also offers a list of 10 questions to ask any provider.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Article updated June 2011 |
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