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
$10
Average
$86
Median
$46
High
$238
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 21.0× 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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25 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $138 | $138 | $101 | 73% | — | $37 – $238 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 3 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 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 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 7 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 8 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 9 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 10 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 11 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $133 | $133 | $105 | 79% | — | $28 – $238 |
| 12 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 13 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 14 | Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 15 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 16 | REEDLEY COMMUNITY HOSPITAL Reedley, CA fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 17 | SONORA COMMUNITY HOSPITAL Sonora, CA fee schedule · outpatient | 1 | $140 | $140 | $98 | 70% | — | $42 – $238 |
| 18 | Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 19 | St Peters Hospital Albany, NY professional · percent of total billed charges · inpatientfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 20 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 21 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 22 | St. Joseph's Mercy Hospital, Centerville Centerville, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 23 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 24 | UKIAH ADVENTIST HOSPITAL Ukiah, CA fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 25 | WILLITS HOSPITAL INC Willits, CA fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
← Payers reporting HCPCS G0403 · Snapshot 20261111T120946Z-9134e7f7