CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: City of Hope National Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $325
Cash Discount Price: $407
vs. Medicare Baseline: 5.39x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at City of Hope National Medical Center is $325. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 5.39x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$407

Average discount available for prompt cash payment at this facility.

Insurance Median

$325

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: $407 (675%)

Insurance Median: $325 (539%)

Cash: $407 (675% of Medicare)

Ins. Median: $325 (539% 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 539% of the Medicare baseline (a markup of 439%). 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
Cal Optima	$7 - $18	12%
Health Net	$9 - $476	15%
Heritage Provider Network	$9 - $285	15%
Inland Empire	$9 - $325	15%
Prime Healthcare Keenan	$13 - $390	22%
Blue Cross Blue Shield	$16 - $285	27%
UnitedHealthcare	$228	378%
Blue Shield	$241 - $485	400%
Blue Shield Covca	$247	410%
Blue Shield Promise	$285	473%
Cencal	$325	539%
La Care Health	$325	539%
Kaiser	$366	607%
Aetna	$406	674%
Gold Coast	$406	674%
Molina	$406 - $528	674%
Cigna	$437	725%
Facey	$447	742%
Healthcare Partners	$472	783%
St. Joseph Heritage	$488	810%
Primecare Medical Network	$528	876%
First Health	$626	1039%
Phcs Multiplan	$732	1215%

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 $407.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93005.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93005.
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.