Cardiac Testing · 93351

Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report

Medicare Payment (avg)
$142.72
What Medicare actually pays
Billed Charge (avg)
$698.90
What providers submit
Markup
4.9x
390% above Medicare rate
177.8K
Total Services
175.5K
Beneficiaries
11.7K
Providers
53
States with Data

Price Range Across States

Lowest State Avg
$57.12
Vermont
Highest State Avg
$193.72
District of Columbia

What You Might Pay

Est. Commercial Insurance
$424.18
Range: $296.93 – $593.85
Est. Cash / Self-Pay
$334.22
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Cardiac Testing procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Prices by State

State Medicare Payment Billed Charge
District of Columbia $193.72 $631.02
California $189.38 $758.75
Maryland $187.45 $714.20
Alaska $187.41 $1,845.36
Puerto Rico $183.48 $235.52
New York $181.56 $950.41
Wyoming $173.67 $2,648.39
New Jersey $169.87 $760.57
Hawaii $160.60 $675.83
Nevada $154.69 $500.29
Texas $148.31 $659.10
Kansas $146.87 $580.45
U.S. Virgin Islands $140.18 $421.99
Rhode Island $136.27 $598.97
Alabama $135.57 $396.64
Montana $134.99 $560.17
Arizona $134.00 $746.37
Florida $133.81 $600.63
Delaware $122.93 $502.66
South Carolina $122.46 $842.62
Mississippi $120.16 $654.44
Virginia $119.98 $455.96
North Carolina $114.45 $599.39
Massachusetts $114.42 $582.66
Nebraska $110.34 $560.46
Colorado $109.24 $596.14
Iowa $108.96 $583.62
Washington $107.48 $611.40
Pennsylvania $104.01 $544.60
Louisiana $102.91 $474.52
Georgia $101.56 $565.62
Oregon $98.75 $419.46
Michigan $96.74 $439.03
Connecticut $93.81 $646.22
Illinois $89.65 $590.90
West Virginia $88.90 $475.14
New Mexico $86.94 $407.02
South Dakota $86.73 $346.79
Arkansas $83.32 $395.64
Minnesota $83.02 $792.40
Wisconsin $80.72 $1,541.73
Utah $78.78 $351.70
Kentucky $78.43 $291.88
Idaho $77.70 $369.85
Oklahoma $77.17 $278.26
Ohio $72.63 $550.35
Indiana $71.63 $391.13
Missouri $71.09 $542.08
New Hampshire $69.79 $466.26
Tennessee $69.54 $350.51
North Dakota $59.72 $394.42
Maine $59.56 $277.24
Vermont $57.12 $182.65

What the Data Says About Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report

Across 53 states with reporting providers, CPT code 93351 (Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report) shows a national average Medicare payment of $142.72 against an average billed charge of $698.90. That gap — a 4.9x markup, or 390% above the Medicare allowed amount — reflects chargemaster pricing, not what most insured patients actually pay. Medicare's negotiated rate is the statutory benchmark; commercial insurers typically settle between the two figures based on network contracts.

Cardiac Testing procedures like this one saw 177.8K services billed to Medicare in 2023 by 11.7K distinct providers, serving 175.5K unique beneficiaries. State-level variation is significant: Vermont reports the lowest average payment at $57.12, while District of Columbia reports the highest at $193.72. Geographic Practice Cost Indices (GPCIs) explain much of that spread — local malpractice premiums, practice expense, and physician work adjustments all shift the allowed amount even when the procedure is identical.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Cardiac Testing category (2.24x), the estimated commercial insurance price lands near $424.18, with self-pay cash discounts commonly bringing the figure closer to $334.22. Uninsured patients facing the full billed charge have the strongest leverage to negotiate — the Hospital Price Transparency Rule (effective January 2021) requires providers to publish standard charges, cash rates, and payer-specific negotiated prices. This data is for educational reference; confirm coverage and out-of-pocket exposure with your insurer before any procedure.

Frequently Asked Questions

How much does Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report cost?

The national average Medicare payment for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report (CPT 93351) is $142.72, while providers typically bill $698.90. Prices vary significantly by state, ranging from $57.12 to $193.72.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report cost with insurance?

With commercial insurance, Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report costs an estimated $424.18 on average (range: $296.93 – $593.85). Without insurance, the estimated cash price is $334.22. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.

Which state has the lowest cost for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report?

Vermont has the lowest average Medicare payment for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report at $57.12, while District of Columbia has the highest at $193.72. This $136.60 difference reflects geographic variation in healthcare costs, local cost of living, and provider market dynamics.

How many providers perform Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report?

Nationally, 11.7K providers billed Medicare for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report in 2023, performing 177.8K total services for 175.5K beneficiaries across 53 states and territories.

What is the billed-to-Medicare markup for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report?

Providers bill 4.9x what Medicare pays for Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercise And/or Drug Induced Stress With Review And Report — a 390% markup. This gap between billed charges and actual payment is common across healthcare. Uninsured patients may face charges closer to the billed amount, while insured patients pay negotiated rates between the Medicare and billed figures.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial