Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR Ekg for Initial Prevent Exam With 12 Leads
Low
$13
Average
$24
Median
$23
High
$41
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 2.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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44 hospital rates
iThe hospitals that file a Excellus rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Alice Hyde Medical Center Malone, NY professional · fee schedule · both | 2 | $16 | $16 | $1 | 7% | — | $15 – $17 |
| 2 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 2 | $19 | $19 | $5 | 28% | — | $14 – $25 |
| 3 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 2 | $19 | $19 | $5 | 28% | — | $14 – $25 |
| 4 | Central Community Hospital Elkader, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 5 | Central Community Hospital Elkader, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 6 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 2 | $15 | $15 | $2 | 13% | — | $13 – $17 |
| 7 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 8 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 2 | $19 | $19 | $5 | 28% | — | $14 – $25 |
| 9 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 10 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 4 | $16 | $20 | $9 | 46% | — | $13 – $41 |
| 11 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 2 | $22 | $22 | $6 | 28% | — | $16 – $28 |
| 12 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 2 | $22 | $22 | $6 | 28% | — | $16 – $28 |
| 13 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 3 | $15 | $14 | $1 | 7% | — | $13 – $15 |
| 14 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 2 | $19 | $19 | $4 | 23% | — | $14 – $23 |
| 15 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $19 | $19 | $4 | 23% | — | $14 – $23 |
| 16 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 17 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 18 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 2 | $19 | $19 | $4 | 23% | — | $14 – $23 |
| 19 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $16 | $16 | $4 | 23% | — | $12 – $19 |
| 20 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · inpatient | 2 | $19 | $19 | $5 | 28% | — | $14 – $25 |
| 21 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · outpatient | 2 | $16 | $16 | $5 | 28% | — | $12 – $21 |
| 22 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 23 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 24 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 2 | $18 | $18 | $4 | 23% | — | $14 – $23 |
| 25 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
← Payers reporting HCPCS G0403 · Snapshot 20261111T120946Z-9134e7f7