Echocardiogram (heart ultrasound)
Facility: Hiawatha Community Hospital
Billing Code: 93306 (CPT)
- CPT Billing Code: 93306
- Insurance Median: $2,346
- Cash Discount Price: $3,011
- vs. Medicare Baseline: 4.20x 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 420% of the Medicare baseline (a markup of 320%). 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 |
|---|---|---|
| UnitedHealthcare | $1,114 - $2,586 | 200% |
| Aetna | $1,114 - $2,433 | 200% |
| Humana | $1,125 | 202% |
| Ambetter / Centene | $1,337 | 239% |
| Blue Cross Blue Shield | $1,456 - $1,532 | 261% |
| Centrus Health Direct - All Plans | $2,258 | 404% |
| Oscar - All Plans | $2,258 | 404% |
| Preferred Hlth - All Plans | $2,710 | 485% |
| Wppa Providrs Care - All Plans | $2,860 | 512% |
| Cigna | $2,860 | 512% |
| Midlands Choice - All Plans | $2,921 | 523% |
| Multiplan - All Plans | $2,921 | 523% |
| Healthy Blue Mcaid - All Plans | $3,011 | 539% |
Consumer Guidance & Cost Commentary
For the Echocardiogram (heart ultrasound) at Hiawatha Community Hospital, the cash price is $3,011, which matches the facility's gross charge and the median paid by patients paying out-of-pocket. While the hospital's negotiated rates for in-network insurers range from $1,114 to $3,011, the cash price is notably higher than the median negotiated rate of $2,346. This scenario highlights a key billing principle: for patients with high-deductible plans who have not yet met their coverage threshold, paying the cash price directly can sometimes be more cost-effective than relying on insurance, which may result in a higher out-of-pocket expense once deductibles are applied. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can significantly reduce the final bill.
The facility's pricing is evaluated against the Medicare benchmark of $558.25, showing a markup of 4.2 times the federal rate, which aligns with typical commercial pricing structures where negotiated rates often exceed 200% of Medicare amounts. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary invoice to identify any unbundled codes or services not rendered. If a patient receives a balance bill from an out-of-network provider at this in-network facility, they are protected under the No Surprises Act, which prohibits providers from charging the difference between the allowed amount and the full chargemaster rate for emergency or non-emergency services.