CMS Price Transparency Data

Echocardiogram (heart ultrasound)

Facility: St James Hospital

Billing Code: 93306 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93306
Insurance Median: $177
Cash Discount Price: $1,042
vs. Medicare Baseline: 0.32x Medicare

The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at St James Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,042. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 0.32x the Medicare baseline. Located in 411 Canisteo Street, Hornell, NY.

Cash / Self-Pay

$1,042

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$558.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $558.25 (100%)

Cash / Self-Pay: $1,042 (187%)

Insurance Median: $177 (32%)

Cash: $1,042 (187% of Medicare)

Ins. Median: $177 (32% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$47 - $480	8%
Fidelis 5155	$50 - $209	9%
Blue Cross Blue Shield	$52 - $1,633	9%
Aetna	$56 - $731	10%
Excellus 2201	$56 - $188	10%
Medicare (plans)	$56 - $804	10%
UnitedHealthcare	$59 - $731	11%
Mvp 2900	$64 - $1,586	11%
Cigna	$88 - $1,643	16%
Capital District Physicians Health Plan (Cdphp) 5149	$169 - $481	30%
Molina Healthcare 1723	$209 - $469	37%
Humana	$731	131%
Empire Plan 5179	$1,541	276%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,042.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93306.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St James Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93306.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.