CMS Price Transparency Data

Electrocardiogram (ECG/EKG)

Facility: Adventist Health Clearlake

Billing Code: 93000 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93000
Insurance Median: $54
Cash Discount Price: $33
vs. Medicare Baseline: 3.52x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (ECG/EKG) at Adventist Health Clearlake is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $15.36, this hospital’s rate is 3.52x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $33 (215%)

Insurance Median: $54 (352%)

Cash: $33 (215% of Medicare)

Ins. Median: $54 (352% 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 352% of the Medicare baseline (a markup of 252%). 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 Mcr Adv	$13 - $25	85%
Kaiser Mcr Adv	$13 - $25	85%
Tricare	$13 - $25	85%
Blue Cross Blue Shield	$14 - $313	91%
UnitedHealthcare	$15 - $98	98%
Ah Employee Health Plan - All Plans	$27 - $49	176%
Bc Managed Mcal	$41	267%
Medi-Cal	$41	267%
Aetna	$48 - $87	313%
Western Growers- All Plans	$48 - $88	313%
Blue Shield Epn - All Other Plans	$49 - $90	319%
Blue Shield Non-Epn	$49 - $90	319%
First Health- All Plans	$51 - $94	332%
Healthnet- All Plans	$52 - $96	339%
Foundation- All Plans	$54 - $99	352%
Health Mgmt Network- All Plans	$54 - $99	352%
Humana	$54 - $99	352%
Phcs- All Plans	$54 - $99	352%
Cigna	$58 - $105	378%
Interplan- All Plans	$58 - $105	378%
Kaiser- All Other Plans	$58 - $105	378%
Three Rivers Provider Network- All Plans	$58 - $105	378%
Partnership Mcal - All Plans	$106 - $193	690%

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 $33.
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 Clearlake 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.