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Screening ECG, 12 Leads, with Interpretation and Report

Montana rates for HCPCS G0403

Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report

Rates data updated October 2026.

How much does Screening ECG, 12 Leads, with Interpretation and Report cost?

$22.39

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $22.39 for this service. The price depends on where it is billed: about $22.39 from a physician practice, and about $26.30 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$22.39$19.05 to $25.70
FacilityA hospital or hospital-owned outpatient department$26.30$19.05 to $26.92

How much rates vary

Facilitymedian $26 · 10th to 90th $15 to $35Professionalmedian $22 · 10th to 90th $15 to $32
$20$50$100facility $26professional $22

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.22
Median
$17.38
Typical High
$25.12
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Cigna
Setting
Facility
Modifier
None
Typical Low
$20.89
Median
$35.48
Typical High
$100.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$15.49
Median
$19.05
Typical High
$28.84
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$15.49
Median
$19.05
Typical High
$28.18
Providence
Setting
Facility
Modifier
None
Typical Low
$20.89
Median
$35.48
Typical High
$100.00
Providence
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$22.39
Typical High
$79.43
United
Setting
Professional
Modifier
None
Typical Low
$25.12
Median
$27.54
Typical High
$33.88

Where Montana sits

The same service costs 3.2 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 15th of 51

$22.39

AK $33.11NY $10.47

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.