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Screening ECG, 12 Leads, Tracing Only

New Hampshire 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

Rates data updated October 2026.

How much does Screening ECG, 12 Leads, Tracing Only cost?

$13.80

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $13.80 for this service. Most negotiated rates run $10.72 to $17.78.

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.

How much rates vary

Professionalmedian $14 · 10th to 90th $7 to $19
$10$20$50professional $14

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
$9.55
Median
$10.72
Typical High
$10.72
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$17.38
Typical High
$18.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$6.46
Median
$6.46
Typical High
$6.46
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$10.72
Typical High
$22.91
United
Setting
Professional
Modifier
None
Typical Low
$10.23
Median
$13.80
Typical High
$23.99
Well Sense
Setting
Professional
Modifier
None
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89

Where New Hampshire sits

The same service costs 3.2 times more in Massachusetts 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.

New Hampshire· 4th of 51

$13.80

MA $15.49NY $4.79

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.