CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Adventist Health Vallejo

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $172
Cash Discount Price: $102
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Adventist Health Vallejo is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.85x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $102 (169%)

Insurance Median: $172 (285%)

Cash: $102 (169% of Medicare)

Ins. Median: $172 (285% 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 285% of the Medicare baseline (a markup of 185%). 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
Medi-Cal	$24	40%
Va Medi-Cal	$24	40%
Blue Shield Mcr Adv	$59	98%
Medicare (plans)	$59	98%
Napa County Mcal Child	$59	98%
Tricare	$59	98%
UnitedHealthcare	$59 - $724	98%
Va Mcr-All Other Plans	$59	98%
Aetna	$72	119%
Blue Shield Behav Hlth	$103 - $511	171%
Blue Shield Non-Epn-All Other Plans	$106 - $527	176%
Ah Employee Health Plan-All Plans	$107	178%
Blue Shield Epn	$108 - $535	179%
Phcs-All Plans	$126 - $624	209%
Western Growers-All Plans	$133 - $658	221%
Healthnet-All Plans	$140 - $696	232%
Blue Cross Blue Shield	$149 - $179	247%
Interplan-All Plans	$149 - $738	247%
Choicecare-All Plans	$160 - $794	265%
Beech Street-All Plans	$172 - $851	285%
Cigna	$183 - $908	304%
Kaiser-All Plans	$188 - $931	312%
Health Management Network-All Plans	$195 - $965	324%
Galaxy Network-All Plans	$206 - $1,022	342%
Three Rivers-All Plans	$206 - $1,022	342%

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 $102.
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 Vallejo 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.