Echocardiogram with Doppler (Transthoracic Heart Ultrasound)
CPT 93306 is a complete transthoracic echocardiogram with Doppler and color flow imaging. It is a major cardiac diagnostic test that uses ultrasound to evaluate heart structure and blood flow. Providers charge an average of $683.82, but Medicare pays only $196.73 (3.5x markup). A key billing trap: some cardiology practices unbundle this code by billing 93306 + 93320 + 93325 separately, even though 93306 already includes Doppler and color flow components.
CPT 93306 at a Glance
- Average provider charge: $683.82
- Medicare rate: $196.73
- Typical markup: 3.5x over Medicare rate
- Independent office range: $300 to $500
- Hospital outpatient range: $800 to $1,500
- Includes: Complete echo + Doppler + color flow
- Setting difference: Same physician fee, hospital adds facility fee
- Beneficiaries (2023): 2.7 million
On this page
How the Medicare Rate Is Calculated
Medicare values every procedure using Relative Value Units (RVUs) across three components, then multiplies by a national conversion factor of $33.4009 (2026). For CPT 93306, the non-facility and facility Practice Expense RVUs are the same, so the physician fee is identical regardless of setting. However, hospitals add a separate facility fee on top.
| Component | What It Covers | RVU |
|---|---|---|
| Work RVU | Physician time, skill, and judgment for interpretation | 1.42 |
| Practice Expense RVU | Ultrasound equipment, sonographer, supplies | 4.39 |
| Malpractice RVU | Professional liability insurance | 0.08 |
| Total RVU | 5.89 | |
| x $33.4009 | 2026 conversion factor | $196.73 |
Medicare Rate by State
Medicare adjusts the national rate based on your location using Geographic Practice Cost Indices (GPCIs). Because 93306 has a large Practice Expense component (the ultrasound equipment), states with higher practice costs see the biggest increase in the Medicare rate.
Medicare Rate by State (2026)
Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.
Sample State Rates
| State | Medicare Pays | Avg. Charge | Markup |
|---|---|---|---|
| Texas (Austin) | $205.02 | $683.82 | 3.3x |
| California (Los Angeles) | $224.60 | $683.82 | 3.0x |
| New York (Manhattan) | $225.08 | $683.82 | 3.0x |
| Florida (Fort Lauderdale) | $200.79 | $683.82 | 3.4x |
| Ohio | $183.99 | $683.82 | 3.7x |
| Mississippi | $175.65 | $683.82 | 3.9x |
| Arkansas | $174.76 | $683.82 | 3.9x |
| Alaska | $228.78 | $683.82 | 3.0x |
Rates shown use 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $683.82 is the 2023 national average from CMS utilization data. Actual charges vary by provider.
What Insured Patients Actually Pay for an Echocardiogram
An echocardiogram is a significant expense. Your insurer negotiates a rate typically between 120% and 250% of Medicare, meaning the allowed amount is usually $240 to $490. What you owe depends on your plan and whether you have met your deductible.
| Your Situation | What You Likely Pay | How It Works |
|---|---|---|
| Copay plan (deductible met) | $50 to $150 | Specialist or diagnostic test copay |
| Coinsurance plan (deductible met) | $48 to $98 | 20% of the negotiated rate ($240 to $490) |
| High-deductible plan (deductible NOT met) | $240 to $490 | Full negotiated rate until deductible is met |
| Medicare Part B | $39.35 | 20% of the Medicare-approved amount ($196.73) |
Where to Get an Echocardiogram for Less
The setting where you get your echocardiogram has a massive impact on cost. Hospital outpatient departments charge 2 to 3 times more than independent cardiology offices for the same test, because of facility fees.
Independent Cardiology Office
- Typical total cost: $300 to $500
- One all-in price (no separate facility fee)
- Same equipment and quality as hospital
- Ask for a cash-pay rate if your deductible is high
Hospital Outpatient Department
- Typical total cost: $800 to $1,500
- Physician fee + separate hospital facility fee
- Even hospital-owned physician offices bill as outpatient
- Higher cost does not mean better quality for this test
Common Billing Problems with Echocardiograms
Unbundling: billing 93306 + 93320 + 93325 separately
This is the most significant billing trap for echocardiograms. CPT 93306 already includes Doppler (93320) and color flow Doppler (93325). Some cardiology practices bill all three codes separately, adding $100 to $300 to the bill. If you see 93320 or 93325 on the same bill as 93306, this is likely an overbilling error. Contact the billing department and request removal of the duplicated codes.
Hospital facility fees
If your echocardiogram is done at a hospital-owned facility, expect a separate facility fee of $200 to $600 on top of the physician charge. This can turn a $200 test into a $600 to $800 total charge. The facility fee appears as a separate line item, sometimes on a different bill. Always check for both the professional (physician) and facility (hospital) charges.
Repeat echocardiograms without clear clinical need
For stable heart conditions, guidelines generally do not support annual echocardiograms. If your cardiologist orders a repeat echo less than a year after your last one and your condition has not changed, ask about the clinical indication. Unnecessary repeat testing is a common source of excess spending in cardiology.
Related Echocardiogram Codes
| Code | Description | Notes |
|---|---|---|
| 93303 | Transthoracic echo without Doppler | Structure only, no blood flow |
| 93306 | Transthoracic echo with Doppler and color flow | This page |
| 93312 | Transesophageal echocardiogram (TEE) | Probe goes down the throat, higher cost |
| 93320 | Doppler echo (should be bundled into 93306) | Watch for unbundling |
| 93325 | Color flow Doppler (should be bundled into 93306) | Watch for unbundling |
Frequently Asked Questions
How much does an echocardiogram cost without insurance?
An echocardiogram with Doppler (CPT 93306) costs $300 to $500 at independent cardiology offices and $800 to $1,500 at hospital outpatient departments. The national average provider charge is $683.82. Medicare pays $196.73 for the physician fee. Cash-pay patients should shop independent cardiology practices for the best price, and always ask for the all-in cost before scheduling.
What is unbundling and how does it affect my echocardiogram bill?
Unbundling is when a provider bills separate codes for components that are already included in a single code. CPT 93306 includes both Doppler (93320) and color flow Doppler (93325). If your bill shows 93306 plus 93320 or 93325 as separate line items, you are likely being overbilled by $100 to $300. These codes should not be billed together. Contact the billing department and cite the CMS National Correct Coding Initiative (NCCI) edits.
What is the difference between 93306 and 93303?
CPT 93303 is a transthoracic echocardiogram without Doppler, while 93306 includes complete Doppler and color flow Doppler imaging. Most echocardiograms today use Doppler, so 93306 is the more commonly billed code. 93303 is used when only the structural imaging (without blood flow assessment) is needed, which is less common.
Why is my echocardiogram bill so much higher at a hospital?
Hospital outpatient departments charge a facility fee on top of the physician fee. While the physician portion is the same $196.73 regardless of setting, the hospital facility fee can add $200 to $600 or more. An independent cardiology office typically charges $300 to $500 total, while hospital outpatient can be $800 to $1,500. The test quality is the same in both settings.
Need Help Lowering a Medical Bill?
CareRoute Bill Defense is a done-for-you bill reduction service. We analyze the codes on your bill, identify overcharges and coding errors (like unbundled echocardiogram codes), and apply negotiation and reduction strategies on your behalf. If you are dealing with a bill that seems too high, we can help.
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