Cardiology · Idaho

Cardiology commercial reimbursement in Idaho

How Idaho cardiology rates compare with the national market.

Cardiology in Idaho

38 codes · 63 sampled providers
Index vs national
106
6% above
Rank among states
18 of 51
1 = highest
Codes above national
29 of 38
median code at 108%
Providers
63
sampled

What the data shows

1

Cardiology ranks 18th of 51 states in Idaho with an index of 106 (100 = the specialty's national median), across 38 codes and 63 sampled providers.

2

Of the 38 cardiology codes with enough data in Idaho, 29 pay above the national median and 9 below; the typical code sits at 108% of the national median.

3

Largest premium over the national median: CPT 78452 (Ht muscle image spect mult) at 130%; largest discount: CPT 93297 (Rem interrog dev eval icpms) at 82%.

4

Measured against Medicare, Idaho cardiology rates have a median of 155% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeIdahoNationalGapProv.
78452
Ht muscle image spect mult
$793$609+30%63
75574
Ct angio hrt w/3d image
$581$495+17%61
99215
Office o/p est hi 40 min
$213$185+16%63
99205
Office o/p new hi 60 min
$288$250+15%63
33361
Replace aortic valve perq
$2,226$1,938+15%63

Lowest vs national

CodeIdahoNationalGapProv.
93297
Rem interrog dev eval icpms
$43$52-18%61
93298
Rem interrog dev eval scrms
$43$52-18%63
93000
Electrocardiogram complete
$23$25-9%63
93015
Cv stress test supvj i&r
$112$120-6%63
93296
Rem interrog evl pm/ids
$37$39-6%63

All cardiology codes in Idaho

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeIdahoNationalGap% of MedicareProvidersTINsLevel
CPT 78452
Ht muscle image spect mult
$793$609+30%185%63121
CPT 75574
Ct angio hrt w/3d image
$581$495+17%179%61118
CPT 99215
Office o/p est hi 40 min
$213$185+16%111%63123
CPT 99205
Office o/p new hi 60 min
$288$250+15%122%63123
CPT 33361
Replace aortic valve perq
$2,226$1,938+15%206%63121
CPT 33285
Insj subq car rhythm mntr
$155$135+14%205%63122
CPT 99204
Office o/p new mod 45 min
$218$192+14%123%63123
CPT 99212
Office o/p est sf 10 min
$58$51+13%97%63123
CPT 36482
Endoven ther chem adhes 1st
$310$278+12%195%61118
CPT 33208
Insrt heart pm atrial & vent
$908$819+11%199%63121
CPT 93280
Pm device progr eval dual
$117$105+11%149%63120
CPT 99214
Office o/p est mod 30 min
$144$131+10%106%63123
CPT 99203
Office o/p new low 30 min
$134$122+9%114%63123
CPT 99213
Office o/p est low 20 min
$99$91+9%104%63123
CPT 20610
Drain/inj joint/bursa w/o us
$91$83+9%132%62121
CPT 99454
Rem mntr physiol param 16-30
$81$75+9%156%61119
CPT 93970
Extremity study
$298$275+8%162%62120
CPT 99490
Chrnc care mgmt staff 1st 20
$64$60+8%97%62119
CPT 93880
Extracranial bilat study
$305$283+8%161%63120
CPT 93229
Remote 30 day ecg tech supp
$1,157$1,088+6%153%61117
CPT 93925
Lower extremity study
$369$349+6%155%62119
CPT 99457
Rpm tx mgmt 1st 20 min
$55$53+4%106%61119
CPT 92928
Prq tcat plmt ntrac st 1 les
$908$887+2%196%63121
CPT 93010
Electrocardiogram report
$13$13+2%154%63122
CPT 93351
Stress tte complete
$373$366+2%160%63120
CPT 93308
Tte f-up or lmtd
$157$155+1%155%63119
CPT 93294
Rem interrog evl pm/ldls pm
$48$48+1%165%63121
CPT 93306
Tte w/doppler complete
$319$317+1%162%63121
CPT 93312
Echo transesophageal
$388$387+0%162%63120
CPT 93016
Cv stress test supvj only
$34$34+0%164%63121
CPT 36465
Njx noncmpnd sclrsnt 1 vein
$185$185-0%176%61118
CPT 93656
Compre ep eval abltj atr fib
$1,614$1,615-0%200%63121
CPT 93458
L hrt artery/ventricle angio
$1,564$1,573-1%155%63122
CPT 93296
Rem interrog evl pm/ids
$37$39-6%116%63121
CPT 93015
Cv stress test supvj i&r
$112$120-6%153%63120
CPT 93000
Electrocardiogram complete
$23$25-9%150%63121
CPT 93298
Rem interrog dev eval scrms
$43$52-18%42%63120
CPT 93297
Rem interrog dev eval icpms
$43$52-18%70%61119

Frequently asked questions

How do Idaho cardiology rates compare with the rest of the country?

Idaho ranks 18th of 51 states with an index of 106; 29 of 38 codes are above the national median.

Which cardiology code has the biggest premium in Idaho?

CPT 78452 (Ht muscle image spect mult), at 130% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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