There are wide ranges of echocardiogram cost requirements between healthcare facilities in the US. In order to develop a projection of how much money will need to be spent in order to have this procedure, one must understand the variables that can affect overall out-of-pocket expenses. Some of the most important factors include the levels of Medicare and Medicaid reimbursement in different regions, degree of healthcare insurance coverage, the customary charges within a specific geographic area, and deductible or coinsurance requirements.
Echocardiography is a medical procedure that creates images of the heart through the use of ultrasound as well as two and three-dimensional imaging technology. The process is also commonly referred to as a sonogram because it allows providers to visualize the internal cardiac structures in order to evaluate and treat a variety of medical conditions. In order to perform the procedure, a transducer is placed on the patient’s chest and a series of sound waves are sent into the body where they are reflected by different types of tissues. The reflected waves are captured by the transducer and are sent to a special computer that is specifically designed to process signals and produce images.
Echocardiograms vs. Electrocardiograms
When evaluating heart conditions, doctors use electrocardiograms and echocardiograms to develop a more informed understanding of how an individual’s cardiac tissues have been affected. While the electrocardiogram is excellent for observing electrical conduction and the resultant electrical activity that occurs during cardiac contraction, ultrasound provides insight into the ability of the heart to pump blood and the extent of tissue damage. Because this procedure is performed on a frequent basis, the echocardiogram cost can result in a large amount of expense that may not be fully covered by certain health insurance plans. Individuals who think they may need to have cardiac studies performed on a regular basis are encouraged to carefully review the specifics of their plan to make sure that they do not end up having to pay large sums out of their own pocket.
Variations in Procedural Approach
There are a couple different types of ultrasound methods that are used to capture images of the heart in cases where specific information is needed to make an accurate diagnosis. The most common types of echocardiograms include the transesophageal, transthoracic, stress, and contrast. The standard approach is to use the transthoracic method where the transducer is placed on the chest. The placement of the transducer in a patient’s esophagus is known as a transesophageal approach and it allows for the capture of better images that might be needed in cases where the transthoracic images are not sufficient for a proper evaluation. A stress echocardiogram is used to observe the functioning of the heart under both resting and active conditions. An individual might be asked to exercise if this type of method is used or drugs can be administered that force the heart to work harder. Contrast is sometimes used while performing a sonogram to capture reflective images that might help evaluate wall thickness. The method and materials being used are important because they can have an impact on the echocardiogram cost.
The Average National Echocardiogram Cost
One of the best sources for information about the average echocardiogram cost in the US is the Centers for Medicare and Medicaid Services (CMS) which provide details about annual reimbursement rates. In 2012, the CMS received claims for 1,555,506 Level II procedures without contrast with an average charge of $2,048.38 and an average payment of $389.11. California had the highest claims with a mean charge of $4,651.12 and an average payment of $689.63 while North Dakota had the lowest claims at an average of $893.60 and with an average payment of $394.06. Based on these statistics, it is reasonable to assume that a procedure like this could cost anywhere from a few hundred dollars to several thousand. A patient who has an insurance plan that covers the bulk of inpatient and outpatient services might not have to pay anything while those who have no insurance might be stuck paying the entire charge.
Prior to having any medical procedure done, it is good to know what the charge will be. Since there are wide variations in rates for different clinics, the ability to compare echocardiogram cost might lead to choosing one over another. Most healthcare clinics will also provide details about the percentage covered by insurance as well as the amount that will be assigned to the patient. Individuals who lack medical coverage might be able to lower their out-of-pocket cost by taking advantage of a special cash pay rate as established by the facility.