93268

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring and review and report by health care professional

Medicare pricing data for 1,913 providers across 39 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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) up to 30 days continuous with symptom monitoring and review and report by health care professional (HCPCS code 93268) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $174.04, but hospitals typically charge $626.29 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$34.81

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $174.04, your out-of-pocket cost would be approximately $34.81. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$174.04
Average Hospital Charge
$626.29
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$626.29
Medicare Allowed$174.04
Medicare Payment$134.36

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $134.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$201$363347+15.5%
California$198$5872851,097+14.0%
New Jersey$197$69988342+13.1%
Connecticut$189$76874397+8.8%
New York$189$681111389+8.5%
Maryland$187$32319206+7.5%
Massachusetts$187$71036111+7.2%
Washington$181$63766256+3.8%
Delaware$176$56821208+1.1%
Michigan$176$5582699+0.9%
Minnesota$174$1,2531426+0.2%
Rhode Island$174$54215174-0.1%
Florida$173$652194828-0.8%
Nevada$171$46652226-1.7%
Virginia$170$54660188-2.1%
Maine$170$3,055165-2.3%
Arizona$169$4431261,127-2.7%
Utah$168$6411145-3.7%
Iowa$167$601936-3.8%
Texas$167$585122374-4.0%
Pennsylvania$167$63397439-4.1%
Wisconsin$167$2,26233141-4.1%
Missouri$167$6061330-4.2%
North Carolina$166$5961439-4.7%
Illinois$165$75574282-5.2%
Kansas$160$45132804-8.1%
Oregon$160$6331233-8.3%
Ohio$159$4792765-8.4%
Georgia$158$88469232-9.4%
South Carolina$156$51130168-10.3%
Tennessee$156$4361882-10.5%
Indiana$155$3981021-10.9%
Colorado$152$449811-12.8%
Oklahoma$151$5191096-13.4%
Louisiana$150$72455163-14.1%
Alabama$147$37627105-15.5%
Mississippi$144$6411396-17.1%
Kentucky$139$5211218-20.0%
Arkansas$124$626812-29.0%

⚠️ 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

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