HCPCS G0403 at Forks Community Hospital

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report

Forks Community Hospital, Forks

Description from CMS's HCPCS Level II code file.

What Forks Community Hospital publishes for this code: as an outpatient

Forks Community Hospital’s prices for HCPCS G0403, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	—	$85.41 – $199
Medicare AdvantageInsurer rates	—	$73.63 – $557
Medicaid managed careInsurer rates	—	$68.81 – $88.57
Other government programInsurer rates	—	$73.63 – $89.55
UnknownInsurer rates	—	$115 – $199
Cash pricePaying yourself, without insurance	—	$159
List priceBefore any discount; few people pay it	—	$199

Lowest and highest amounts Forks Community Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-10-27. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G0403 at Forks Community Hospital
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G0403 at every Washington hospital, with Medicare’s reference amounts.