93242

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days

Medicare pricing data for 11,659 providers across 50 states

🤖AI Overview

This procedure has a 6.5x markup — hospitals charge $76.33 but Medicare allows only $11.76. Uninsured patients may face bills 6.5 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

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days (HCPCS code 93242) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.76, but hospitals typically charge $76.33 — a 6.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.76, your out-of-pocket cost would be approximately $2.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.76
Average Hospital Charge
$76.33
Markup Ratio
6.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$76.33
Medicare Allowed$11.76
Medicare Payment$9.03

Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $9.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$14$5621303+21.3%
New York$14$738179,433+18.3%
California$14$9599316,189+17.1%
New Jersey$14$644205,867+16.3%
Hawaii$13$6813208+12.0%
Massachusetts$13$652081,808+11.9%
Connecticut$13$941631,293+11.7%
Alaska$13$13543504+10.1%
Maryland$13$463084,523+8.7%
Washington$13$532342,332+7.7%
Virginia$13$552802,280+6.4%
New Hampshire$12$14579306+5.9%
Rhode Island$12$411496+4.6%
Colorado$12$481631,182+3.6%
Delaware$12$5119362+2.9%
Minnesota$12$572161,129+2.0%
North Dakota$12$483085+1.4%
Montana$12$4150238+0.4%
Nevada$12$4650542+0.2%
Oregon$12$531161,023-1.1%
South Dakota$12$12530102-2.1%
Florida$11$3980012,990-2.8%
Michigan$11$423062,573-3.2%
Wisconsin$11$113168760-3.2%
Vermont$11$52631-3.3%
Maine$11$382270-3.8%
Utah$11$4750518-5.1%
Arizona$11$342404,088-5.3%
Illinois$11$1372707,197-6.2%
North Carolina$11$737826,144-6.6%
Ohio$11$373272,382-6.6%
Pennsylvania$11$13276310,912-6.6%
Indiana$11$812361,751-7.9%
New Mexico$11$3927208-8.0%
South Carolina$11$392492,582-8.2%
Missouri$11$581871,604-8.5%
Georgia$11$683172,262-8.9%
Nebraska$11$5186665-8.9%
Texas$11$11687615,862-9.3%
Iowa$11$85100800-10.1%
Oklahoma$11$3175493-10.1%
Kentucky$11$412031,654-10.5%
Kansas$10$42115894-11.0%
Tennessee$10$385204,773-11.3%
Louisiana$10$501693,120-12.0%
West Virginia$10$8235557-12.6%
Alabama$10$332332,303-12.8%
Idaho$10$6038142-13.9%
Arkansas$10$391282,149-14.6%
Mississippi$10$7154570-16.2%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber