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Maryland rates for HCPCS G0404

Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.96 / $7.19 / $10.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.65 / $5.65 / $5.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.69 / $13.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $11.39 / $17.39
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $7.70 / $9.35