CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $23
Cash Discount Price: $174
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Shriners Hospitals for Children Northern Calif is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 0.38x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $174 (289%)

Insurance Median: $23 (38%)

Cash: $174 (289% of Medicare)

Ins. Median: $23 (38% 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
Soonercare	$5	8%
Ambetter / Centene	$7 - $88	12%
Amerigroup Nv	$7	12%
Health Plan Of Nv	$7	12%
Gateway Health Plan	$10	17%
Aetna	$19 - $77	32%
Blue Cross Blue Shield	$19 - $23	32%
Central California Alliance For Health	$19	32%
Health Plan Of San Joaquin	$19	32%
Kaiser Permanente	$19	32%
Molina Healthcare Of Ca	$19	32%
Partnership Healthplan Of Ca	$19	32%
Medicaid / KanCare	$21	35%
Molina Healthcare Of Ms	$58	96%
Amerihealth Caritas Nc	$66	110%
Amerihealth Caritas Sc	$66	110%
Caresource Of Oh	$66	110%
Cigna	$68	113%
Northbay Healthcare	$77	128%
Sana Benefits	$81 - $107	134%
Sutter Medical Foundation	$84	139%
Health Net Of Ca	$88	146%
Healthchoice Of Oklahoma	$101	168%

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 $174.
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 Shriners Hospitals for Children Northern Calif 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.