What do doctors typically charge for Ultrasound of Heart for Congenital Defect?

The nationwide median physician charge for Ultrasound of Heart for Congenital Defect (CPT 93304) is $133.55. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 93304?

The standard insurance baseline reimbursement rate is $35.41. This represents the customary allowable amount established across standard fee schedules.

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CPT 93304Medical Service

Ultrasound of Heart for Congenital Defect

Q: What is Ultrasound of Heart for Congenital Defect (CPT 93304)?

Ultrasound of heart for congenital defect, follow-up. This clinical code is utilized across practices and hospitals for diagnostic and therapeutic service documentation.

Ultrasound of heart for congenital defect, follow-up. Clinical pricing breakdown and utilization metrics across 14 practicing doctors nationwide.

$133.55

Peer Median Charge

Gross billed rate

$35.41

Standard Baseline

Customary allowable

3.8x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $133.55. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $35.41 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 93304 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"