Echocardiogram (heart ultrasound)
Facility: Rooks County Health Center
Billing Code: 93306 (CPT)
- CPT Billing Code: 93306
- Insurance Median: $2,165
- Cash Discount Price: $1,804
- vs. Medicare Baseline: 3.88x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $558.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 388% of the Medicare baseline (a markup of 288%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Admin - All Plans | $1,130 | 202% |
| Tricare | $1,130 | 202% |
| Celtic Mcr Adv | $1,130 | 202% |
| Celtic Comm - All Other Plans | $1,243 | 223% |
| Blue Cross Blue Shield | $1,532 | 274% |
| Aetna | $2,164 | 388% |
| Preferred Benefits Admin | $2,164 | 388% |
| UnitedHealthcare | $2,164 | 388% |
| Preferred Hlthcare - All Other Plans | $2,285 | 409% |
| Health Partners - All Plans | $2,285 | 409% |
| Healthy Blue Mcaid - All Plans | $2,405 | 431% |
Consumer Guidance & Cost Commentary
For the Echocardiogram (heart ultrasound) procedure at Rooks County Health Center in Plainville, KS, the facility's negotiated rates range from $1,130 to $2,405 depending on the insurance plan. The lowest negotiated rate of $1,130 is significantly lower than the facility's cash price of $1,804, suggesting that for patients with high-deductible plans, paying out-of-pocket might be more cost-effective than using insurance, provided the patient qualifies for a prompt-pay discount. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific county or state average for comparison, so the focus remains on the direct comparison between the facility's cash rate and the lowest available insurance negotiated rate.
The Medicare benchmark for this service is $558.25, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $1,804 represents a substantial markup over the Medicare amount, while the median negotiated rate across payers is $2,165. Patients should be aware that prompt-pay discounts, which can reduce bills by 20% to 50%, are often available for upfront payment and should be requested before check-in to avoid automatic claims submission. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients should verify that all ancillary services, such as lab tests or imaging, are covered under the facility's network agreements to prevent unexpected additional charges.