93016

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

Medicare pricing data for 22,491 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

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician (HCPCS code 93016) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.43, but hospitals typically charge $89.33 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.09

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.43, your out-of-pocket cost would be approximately $4.09. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$20.43
Average Hospital Charge
$89.33
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$89.33
Medicare Allowed$20.43
Medicare Payment$15.45

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $15.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$24$18848921+19.4%
New York$22$881,01135,083+8.0%
District of Columbia$22$7640590+7.9%
California$22$1001,59943,844+7.3%
Connecticut$22$872946,597+6.4%
New Jersey$22$9384432,122+6.1%
Massachusetts$21$9859829,233+4.5%
Hawaii$21$69711,816+3.3%
Rhode Island$21$57861,759+2.6%
Maryland$21$772787,033+2.5%
Illinois$21$11683943,454+2.0%
Puerto Rico$21$4435308+1.8%
Minnesota$21$11950013,534+0.5%
Florida$21$731,52646,172+0.4%
Michigan$21$7283926,139+0.4%
Pennsylvania$20$1091,09337,665+0.1%
Virginia$20$7051515,7450.0%
Arizona$20$603769,111-0.2%
New Mexico$20$73772,837-0.7%
Delaware$20$161793,081-0.8%
Vermont$20$104381,561-1.0%
Texas$20$791,47840,371-1.1%
Washington$20$6351316,801-1.1%
Oregon$20$682694,352-1.1%
North Dakota$20$95793,704-1.3%
Colorado$20$5932810,150-1.5%
Missouri$20$8544924,478-1.6%
Ohio$20$831,20442,451-1.8%
Georgia$20$8585427,313-1.8%
Nevada$20$68732,556-2.0%
New Hampshire$20$1461786,930-2.2%
Tennessee$20$6953527,412-2.3%
Oklahoma$20$7330415,487-2.4%
North Carolina$20$9486122,931-2.4%
Alabama$20$7130810,223-2.8%
South Dakota$20$741057,000-2.8%
Mississippi$20$972199,220-3.2%
West Virginia$20$981515,867-3.2%
Maine$20$821404,003-3.5%
Wisconsin$20$23858715,707-3.6%
Iowa$20$7826610,468-3.9%
Indiana$20$8256027,962-4.0%
Kansas$20$8829010,504-4.0%
Idaho$20$571124,242-4.1%
Arkansas$20$5422011,606-4.2%
South Carolina$20$10338613,518-4.3%
Louisiana$19$7238711,710-4.8%
Nebraska$19$612635,452-5.3%
Kentucky$19$6431411,547-5.8%
Wyoming$19$160441,233-7.9%
Montana$19$77722,555-8.0%
Utah$18$611394,529-10.3%

⚠️ 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