Echocardiogram (heart ultrasound)
Facility: Decatur Health
Billing Code: 93306 (CPT)
- CPT Billing Code: 93306
- Insurance Median: $2,171
- Cash Discount Price: $2,561
- vs. Medicare Baseline: 3.89x 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 389% of the Medicare baseline (a markup of 289%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $1,707 | 306% |
| UnitedHealthcare | $1,735 - $2,171 | 311% |
| Humana | $1,753 | 314% |
| Blue Cross Blue Shield | $1,973 | 353% |
| Midlands Choice- All Plans | $2,561 | 459% |
| Aetna | $2,561 - $2,845 | 459% |
| Medicaid / KanCare | $2,874 | 515% |
Consumer Guidance & Cost Commentary
For the Echocardiogram (heart ultrasound) at Decatur Health in Oberlin, Kansas, the cash price of $2,561 is significantly lower than the facility's negotiated rates with major insurers like Aetna, which range from $2,561 to $2,845. This aligns with the national trend where cash-pay options can be more affordable than insurance-covered services, particularly for patients with high-deductible plans who may not yet have met their out-of-pocket maximum. While the facility's negotiated average of $2,171 is lower than the gross charge of $2,845, it remains higher than the cash price, illustrating how administrative costs and insurance processing fees often inflate the final bill for insured patients compared to self-pay.
The Medicare benchmark for this service is $558.25, which serves as the objective baseline for evaluating pricing fairness. The facility's cash rate of $2,561 represents a 3.9x markup over the Medicare amount, which is consistent with commercial pricing structures that typically range from 200% to 300% of Medicare rates. To minimize costs, patients should verify if their specific insurance plan allows for prompt-pay discounts, which can reduce bills by 20% to 50% if settled upfront. Additionally, consumers are advised to request a full itemized bill before paying, as summary invoices may obscure unbundled charges or services not rendered, ensuring they are only paying for the actual care received.