CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Valley Children's Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $288
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.78x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Valley Children's Hospital is $288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.78x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$288

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%)
Insurance Median: $288 (478%)
Ins. Median: $288 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
Allcare Ipa $19 32%
Community Care Ipa $19 - $30 32%
Kaiser $19 - $335 32%
Dignity Ipa_Formerly Img $26 43%
La Salle Ipa $26 43%
Sante Ipa $26 43%
Central Valley Medical Providers Ipa $28 - $258 46%
Sequoia Health Ipa $28 46%
Univseral Healthcare Ipa $28 46%
United Physicians Network Ipa $29 48%
Adventist $33 55%
Blue Cross Blue Shield $34 - $292 56%
Cencal Health $37 61%
Kern Family Health Care $38 63%
Health Net $181 - $337 300%
Dignity Health Central Coast $255 423%
Community Health $283 470%
Stanislaus Partners In Health $283 470%
Physicians Choice Medical Group $288 478%
Health Plan Of San Joaquin $309 513%
Fowler Packing $319 529%
Dignity (Formerly Managed Care Systems) $324 538%
Kern Legacy $335 556%
Blue Shield $344 - $391 571%
UnitedHealthcare $344 - $367 571%
Aetna $345 572%
First Health Formerly Coventry $381 632%
Bakersfield Family Medical Group $386 640%
Network By Design $399 662%
Community Care Health Plan $412 684%
Health Smart $412 684%
Key Medical Ipa $412 684%
Sutter Health $438 727%
Multiplan $493 818%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens