What is the top of the local market (P90) for CPT 93000 under Highmark Blue Shield (PA) for Providence-Warwick, RI-MA providers?

The P90, the top of the local market and Reddenda's target rate, is $31.08.

How does Highmark Blue Shield (PA)'s rate for CPT 93000 compare to Medicare?

The Highmark Blue Shield (PA) local median of $14.25 is 93% of Medicare's national non-facility rate of $15.36 for CPT 93000.

Reddenda · Rate Intelligence · Providence-Warwick, RI-MA

93000 under Highmark Blue Shield (PA), for Providence-Warwick, RI-MA providers

Name: Highmark Blue Shield (PA) rates for CPT 93000 among Providence-Warwick, RI-MA providers
Creator: Reddenda

Electrocardiogram, complete · Local peer median $14.25 · Medium confidence

$14.25 local peer median. Highmark Blue Shield (PA)'s published rate file lists a local peer median of $14.25 for CPT 93000 (Electrocardiogram, complete) among 386 indexed providers in Providence-Warwick, RI-MA. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $31.08, 118% above the median. A provider billed below this median is being paid less than peers holding the identical Highmark Blue Shield (PA) contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 386 providers · 386 rate records

P10

$14.25

P25

$14.25

Median

$14.25

P75

$14.25

P90 (target)

$31.08

P10$14.25

P25$14.25

Median (P50)$14.25

P75$14.25

P90 target$31.08

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $8.02 – $89.17

The local peer median for CPT 93000 under Highmark Blue Shield (PA) for Providence-Warwick, RI-MA providers is $14.25, drawn from 386 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
The bottom of the local market (P10) is $14.25 and the top (P90) is $31.08; the median-to-P90 spread is $16.83.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
The lowest published rate in this market is $8.02; the highest is $89.17.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
This benchmark is drawn from 386 individual rate records that Highmark Blue Shield (PA) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
Medicare's national non-facility rate for CPT 93000 is $15.36, making the Highmark Blue Shield (PA) local median 93% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
80.3% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

386 providers bill this code to this payer in this metro.

Find yourself on this curve. Enter your NPI: no account, no email, no PHI.

Free, forever, unmetered. Possession-channel verification only if you choose to claim the record; looking is always free.

See where your rate lands

These are the rates Highmark Blue Shield (PA) publishes for CPT 93000 (Electrocardiogram, complete) among Providence-Warwick, RI-MA providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

Run a free RateScore on your NPI → Talk to us about Highmark Blue Shield (PA)

Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Highmark Blue Shield (PA)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Highmark Blue Shield (PA) to publish this rate. Page generated 2026-08-23 23:09 UTC; the live index is queried in real time on every request.