CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Adventist Health Tulare

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $85
Cash Discount Price: $93
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Adventist Health Tulare is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.41x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$93

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $93 (154%)

Insurance Median: $85 (141%)

Cash: $93 (154% of Medicare)

Ins. Median: $85 (141% 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.

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
Medi-Cal	$24	40%
Dignity Mcal Op Only	$26	43%
Independence Op Only - All Plans	$26	43%
Blue Cross Blue Shield	$28 - $158	46%
Ccipa Medi-Cal - All Plans	$31	51%
Healthnet Medi-Cal	$31	51%
Blue Shield Epn	$72	119%
Blue Shield Mcare	$76	126%
Dignity Mcr Op Only - All Other Plans	$76	126%
Fhcn Pace Mcr Adv - All Plans	$76	126%
Medicare (plans)	$76	126%
Prime Health - All Plans	$76	126%
Tricare	$76	126%
UnitedHealthcare	$76	126%
Aetna	$85	141%
Prison Hlthcre - All Plans	$97	161%
Blue Shield-All Other Plans	$99	164%
Cal Forensic Med Grp - All Plans	$99	164%
Bright Health - All Plans	$110	183%
Ah Employee Health Plan - All Plans	$137	227%
Incentive Hlth - All Plans	$137	227%
Healthnet Hmo/Ppo - All Other Plans	$202	335%
Cigna	$226	375%
Western Growers - All Plans	$229	380%
Network By Design-All Plans	$317	526%
Hs Interplan-All Plans	$327	543%
Multiplan - All Plans	$415	689%

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 $93.
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 Tulare 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.