CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Adventist Health Sierra Vista

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $784
Cash Discount Price: $130
vs. Medicare Baseline: 13.01x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Adventist Health Sierra Vista is $784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 13.01x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$784

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: $130 (216%)

Insurance Median: $784 (1301%)

Cash: $130 (216% of Medicare)

Ins. Median: $784 (1301% 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 1301% of the Medicare baseline (a markup of 1201%). 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
Aetna	$76 - $952	126%
Cencal Mcr Adv - All Other Plans	$76	126%
Tricare	$76	126%
UnitedHealthcare	$76 - $615	126%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$98	163%
Ah Employee Health Plan - All Plans	$136	226%
Hpn-Heritage Prov Ntwrk-All Plans	$462 - $522	767%
Blue Shield Epn	$532 - $602	883%
Blue Shield Hmo/Pos	$663 - $750	1100%
Blue Shield Epo/Ppo-All Other Plans	$731 - $826	1213%
Nbd-Ntwrks By Design Exclus-All Other Plans	$784 - $887	1301%
Nbd-Ntwrks By Design Non-Exclus	$784 - $887	1301%
Medi-Cal	$1,358 - $1,536	2253%
Cencal Mcal	$1,548 - $1,751	2568%
Blue Shield Promise Mcal	$1,632 - $1,846	2708%
Ccah-Centrl Ca Allince Mcal-All Plans	$1,765 - $1,997	2928%
Coalinga-All Plans	$1,765 - $1,997	2928%

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 $130.
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 Adventist Health Sierra Vista 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.