92978

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel

Medicare pricing data for 6,746 providers across 52 states

🤖AI Overview

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

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel (HCPCS code 92978) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $93.28, but hospitals typically charge $408.78 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $93.28, your out-of-pocket cost would be approximately $18.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$93.28
Average Hospital Charge
$408.78
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$408.78
Medicare Allowed$93.28
Medicare Payment$74.47

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $74.47 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$118$75312306+26.2%
New York$109$5584097,686+17.0%
District of Columbia$101$33820456+8.4%
Illinois$98$4552734,133+5.5%
New Jersey$98$6581912,680+5.4%
Florida$98$3645035,453+5.4%
Maryland$98$52376961+4.8%
Michigan$98$4072793,666+4.7%
Connecticut$96$653791,125+3.3%
Massachusetts$96$3581332,335+2.5%
California$94$3705457,376+0.5%
Rhode Island$93$31518250-0.1%
Nevada$93$341681,000-0.6%
Virginia$93$2801712,833-0.6%
Delaware$93$27817102-0.7%
West Virginia$92$26644647-1.0%
Washington$92$2861443,429-1.3%
Pennsylvania$92$4212803,513-1.4%
Puerto Rico$92$3011451-1.5%
New Hampshire$92$76125601-1.5%
Colorado$92$307911,367-1.7%
New Mexico$92$30325577-1.8%
Louisiana$91$5911461,456-2.0%
Ohio$91$3102693,833-2.4%
Georgia$91$4092023,476-2.5%
Hawaii$91$21611196-2.7%
Missouri$91$4111653,079-2.7%
Montana$91$35629522-2.8%
Wyoming$91$1,1595160-2.9%
Texas$90$4096115,764-3.1%
Oregon$90$307671,152-3.8%
Arizona$89$2551912,841-4.1%
Utah$89$30337648-4.4%
Oklahoma$88$2381081,383-5.4%
Kentucky$88$2351101,749-5.7%
Kansas$88$38456933-6.1%
North Carolina$87$5121872,671-6.3%
Alabama$87$36796859-6.8%
South Carolina$87$4521111,324-6.9%
Maine$86$26216230-7.3%
Minnesota$86$4181061,427-7.5%
North Dakota$86$53518262-7.7%
Iowa$86$40458587-7.9%
Vermont$85$52010216-8.6%
Mississippi$85$42563604-8.6%
Nebraska$85$28142846-8.7%
South Dakota$85$16516554-9.1%
Indiana$85$2871512,063-9.4%
Wisconsin$84$1,0211241,201-9.6%
Idaho$84$25029396-10.0%
Arkansas$84$347851,006-10.1%
Tennessee$83$3631632,173-10.6%

⚠️ 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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