93042

Electrocardiogram (ecg) 1 to 3 leads with review by physician only

Medicare pricing data for 7,842 providers across 51 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $49.73 but Medicare allows only $6.88. Uninsured patients may face bills 7.2 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Electrocardiogram (ecg) 1 to 3 leads with review by physician only (HCPCS code 93042) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.88, but hospitals typically charge $49.73 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.88, your out-of-pocket cost would be approximately $1.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.88
Average Hospital Charge
$49.73
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$49.73
Medicare Allowed$6.88
Medicare Payment$5.39

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $5.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$9$147571,629+32.6%
New York$7$3336415,064+7.6%
District of Columbia$7$32631,210+6.2%
Connecticut$7$42341,260+5.2%
California$7$5390330,108+2.9%
Maryland$7$432998,984+1.9%
New Jersey$7$5755238,746+1.7%
Illinois$7$5150027,687+0.9%
Florida$7$4956913,848+0.6%
Louisiana$7$4840994+0.1%
South Carolina$7$58338680.0%
Delaware$7$39692,569-0.1%
Pennsylvania$7$3940019,476-0.4%
Puerto Rico$7$377104-0.4%
New Mexico$7$6117460-1.0%
Rhode Island$7$36611,318-1.3%
Ohio$7$492524,095-1.5%
Washington$7$7131712,624-1.5%
Massachusetts$7$362079,416-1.6%
Michigan$7$4341110,770-1.7%
Georgia$7$691572,362-2.9%
Hawaii$7$7722393-2.9%
Virginia$7$342213,947-3.2%
Oregon$7$46991,124-3.3%
Missouri$7$581022,409-3.8%
Texas$7$395379,140-3.8%
Wisconsin$7$5656831-3.9%
Arkansas$7$58757-3.9%
Colorado$7$461192,834-3.9%
West Virginia$7$6214312-4.1%
Nevada$7$109117786-4.2%
North Dakota$7$5617113-4.5%
Kansas$7$501790-4.9%
Utah$7$481576,231-4.9%
Wyoming$7$4012216-5.1%
Indiana$7$521432,689-5.4%
Oklahoma$7$62591,460-5.5%
Kentucky$6$5934420-5.8%
Montana$6$57439-5.8%
North Carolina$6$501332,220-5.8%
Idaho$6$6515552-6.5%
Arizona$6$681801,698-6.5%
South Dakota$6$55218-7.1%
Tennessee$6$531312,729-7.3%
Minnesota$6$50401,541-8.0%
Alabama$6$20814,197-10.2%
Mississippi$6$67771,621-10.3%
Iowa$6$5139318-10.6%
New Hampshire$6$29330-11.0%
Maine$6$465104-11.8%
Nebraska$6$61342,491-12.6%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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