CMS Price Transparency Data

Electrocardiogram (ECG/EKG)

Facility: Adventist Health St Helena

Billing Code: 93000 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93000
Insurance Median: $142
Cash Discount Price: $40
vs. Medicare Baseline: 9.24x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (ECG/EKG) at Adventist Health St Helena is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $15.36, this hospital’s rate is 9.24x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$15.36

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.36 (100%)

Cash / Self-Pay: $40 (260%)

Insurance Median: $142 (924%)

Cash: $40 (260% of Medicare)

Ins. Median: $142 (924% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $15.36 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 924% of the Medicare baseline (a markup of 824%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Shield Bh Mcr Adv	$18	117%
Blue Shield Mcr Adv	$18	117%
Kaiser Mcr Adv	$18	117%
Tricare	$18	117%
UnitedHealthcare	$18 - $203	117%
Va Mcr - All Other Plans	$18	117%
Ah Employee Health Plan - All Plans	$20 - $33	130%
Cigna	$21 - $255	137%
Interplan-All Plans	$22 - $207	143%
Kaiser-All Other Plans	$22 - $255	143%
Western Growers-All Plans	$26 - $185	169%
Medi-Cal	$29	189%
Aetna	$34 - $122	221%
Phcs-All Plans	$37 - $175	241%
Va Medi-Cal	$41	267%
Blue Shield Epn-All Other Plans	$44 - $150	286%
Blue Cross Blue Shield	$46 - $309	299%
Blue Shield Non-Epn	$47 - $148	306%
Health Management Network-All Plans	$57 - $271	371%
Three Rivers-All Plans	$60 - $287	391%
Blue Shield Behav Hlth	$119 - $144	775%
Healthnet-All Plans	$162 - $196	1055%
Choicecare-All Plans	$186 - $223	1211%
Beech Street-All Plans	$199 - $239	1296%
Galaxy Network-All Plans	$238 - $287	1549%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $40.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93000.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93000.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.