CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Sonoma Valley Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $542
  • Cash Discount Price: $559
  • vs. Medicare Baseline: 8.99x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Sonoma Valley Hospital is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $559. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 8.99x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$559

Average discount available for prompt cash payment at this facility.

Insurance Median
$542

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$60.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $60.27 (100%)
Cash / Self-Pay: $559 (927%)
Insurance Median: $542 (899%)
Cash: $559 (927% of Medicare)
Ins. Median: $542 (899% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $60.27 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 899% of the Medicare baseline (a markup of 799%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medi-Cal $24 40%
Mcal Mgd Care (Php)-All Plans $39 65%
Tricare $80 133%
Blue Cross Blue Shield $81 - $524 134%
Bright Hlth/Brand New Day Mcr Adv $81 134%
Hospice Of Marin-All Plans $81 134%
St Joseph Heritage Hltcare Comm-All Other Plans $81 134%
Veterans Admin-All Plans $81 134%
Partnership Healthplan-All Plans $82 136%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $85 141%
Cdcr Prison-All Plans $97 161%
Three Rivers (Trpn)-All Plans $97 161%
Chp - Correctional Health Partners - All Plans $105 174%
Bright Hlth/Brand New Day - All Other Plands $110 183%
Wellpath - All Plans $114 189%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $146 242%
Canopy Health Solutions-All Other Plans $146 242%
UnitedHealthcare $154 256%
Healthnet Hmo/Ppo-All Other Plans $312 518%
Blue Shield Ppo-All Plans $454 753%
Kaiser-All Plans $519 861%
Aetna $559 927%
First Health(Coventry)-All Plans $559 927%
Integrated Health Plan-All Plans $591 981%
Champus-All Plans $639 1060%
Cigna $639 1060%
Networks By Design - All Plans $639 1060%
Comm Care Network(Ccn)-All Plans $679 1127%
Great West-One Health Plan Ppo/Pos-All Plans $679 1127%
Phcs/Multiplan/Beech St-All Plans $679 1127%
Interplan-All Plans $703 1166%
Bps-All Plans $719 1193%
Ppo Alliance-All Plans $719 1193%
Pref Health Networl(Phn)-All Plans $719 1193%
Meritage Medical Network Op Only Mcare $799 1326%
Scan Mcare-All Plans $799 1326%
St Joseph Heritage Hltcare Mcr Adv $799 1326%
Correct Care Integ Health-All Plans $959 1591%
Employer Direct Healthcare-All Plans $959 1591%
Meritage Medical Network Op Only-All Other Plans $1,007 1671%
Creative Legal Services-All Plans $1,039 1724%
Canopy Op Only $1,438 2386%
Vnpn - All Plans $1,438 2386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals