93243

Heart rhythm analysis and report of continous external ekg over more than 48 hours up to 7 days

Medicare pricing data for 280 providers across 18 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $1,526 but Medicare allows only $264.99. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $23 in Kentucky to $279 in California. Where you get this procedure matters more than almost any other factor. 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 analysis and report of continous external ekg over more than 48 hours up to 7 days (HCPCS code 93243) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $264.99, but hospitals typically charge $1,526 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$53.00

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $264.99, your out-of-pocket cost would be approximately $53.00. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$264.99
Average Hospital Charge
$1,526
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,525.85
Medicare Allowed$264.99
Medicare Payment$204.28

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $204.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$279$1,08451115,917+5.4%
Maryland$273$3,522141,229+2.9%
New Jersey$269$9091525,878+1.6%
Pennsylvania$256$3,4991234,539-3.6%
Texas$246$4233838,270-7.3%
Illinois$236$3,4971120,317-11.0%
Georgia$227$1,0593207-14.3%
New York$226$755738-14.7%
Arizona$215$350211-19.0%
Florida$214$2,63916137-19.2%
Massachusetts$208$436736-21.6%
Ohio$207$39215295-22.0%
Tennessee$204$2,0636298-23.1%
Delaware$203$359513-23.6%
Louisiana$202$26614682-23.7%
Arkansas$195$422346-26.5%
North Carolina$92$114637-65.2%
Kentucky$23$35622-91.3%

⚠️ 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