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
ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION
Low
$6
Average
$69
Median
$39
High
$477
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
31 hospitals; the 90th percentile is 9.7× 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 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $31 | $31 | — | — | 1–10 | $31 – $31 |
| 2 | Alice Hyde Medical Center Malone, NY professional · fee schedule · both | 2 | $7 | $7 | $0 | 6% | — | $7 – $7 |
| 3 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 2 | $7 | $7 | $1 | 13% | — | $6 – $7 |
| 4 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 5 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 6 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 2 | $7 | $7 | $2 | 28% | — | $5 – $9 |
| 7 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 2 | $9 | $9 | $2 | 28% | — | $6 – $11 |
| 8 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 9 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 10 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 11 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $82 | $82 | $18 | 21% | — | $65 – $100 |
| 12 | Highland Hospital Rochester, NY fee schedule · outpatient | 8 | $41 | $38 | $12 | 31% | — | $26 – $56 |
| 13 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $477 | $477 | — | — | — | $477 – $477 |
| 14 | MVHS, Inc. Utica, NY other · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 15 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 2 | $14 | $14 | — | — | — | $14 – $14 |
| 16 | MVHS, Inc. Utica, NY percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 17 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 2 | $39 | $39 | — | — | — | $39 – $39 |
| 18 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 19 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 20 | Mercy Medical Center-Clinton Inc Clinton, IA facility · fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 21 | Mishawaka Medical Center Mishawaka, IN facility · other · both | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 22 | Mount Carmel East Reynoldsburg, OH facility · other · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 23 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 24 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · other · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 25 | Mount Carmel St Ann's Lewis Center, OH facility · other · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
← Payers reporting HCPCS G0404 · Snapshot 20261111T120946Z-9134e7f7