CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: North Shore Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $270
  • Cash Discount Price: $1,347
  • vs. Medicare Baseline: 4.48x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at North Shore Medical Center is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,347. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.48x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$1,347

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $1,347 (2235%)
Insurance Median: $270 (448%)
Cash: $1,347 (2235% of Medicare)
Ins. Median: $270 (448% 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 448% of the Medicare baseline (a markup of 348%). 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
Healthsun Health Plans $7 - $60 12%
Employer Direct Healthcare $8 - $58 13%
Self Pay/Uninsured $8 - $72 13%
Avmed Broad Network $10 17%
Humana $17 - $553 28%
Medicaid / KanCare $17 - $1,385 28%
UnitedHealthcare $17 - $729 28%
Aetna $39 - $997 65%
Veterans Administration Mill Bill $40 66%
Medicare (plans) $52 - $1,385 86%
Leon Health Inc $57 95%
Devoted Health $58 96%
Hospice Other $58 96%
Tricare $58 96%
Veterans Administration Vaccn $58 96%
Cigna $60 - $693 100%
Longevity Health Plan $61 101%
Florida Pace Centers $69 114%
Bright Health Management Commercial $70 116%
Centurion Prison $72 119%
Oscar Health Plan Hix $80 - $85 133%
Avmed Exchange $102 169%
Ambetter / Centene $108 179%
Molina Marketplace Program Exchange $111 184%
Auto Insurance $117 194%
Avmed Select Network $120 199%
Amerihealth Caritas Next Exchange $126 209%
Imagine Health $131 - $139 217%
Bc/Bs Myblue Hmo Hix $135 224%
Bc/Bs Of Fl Simplyblue $142 236%
Bc/Bs Of Fl Network Blue $190 315%
Bc/Bs Of Fl Health Options Hmo $193 320%
Bc/Bs Of Fl Ppo $203 337%
Bc/Bs Of Fl Blue Select Exchange Non Par $211 350%
Bc/Bs Of Fl Phs $679 - $718 1127%
Magellan Behavioral Health $785 - $831 1302%
Dimensions International $851 - $900 1412%
First Health $890 - $942 1477%
Dimension Health Ppo $982 - $1,039 1629%
Dimension Health Wc $982 - $1,039 1629%
Workers Compensation $982 - $1,039 1629%
Beacon Health Strategies Commercial $1,309 - $1,385 2172%
Commercial Non-Contracted $1,309 - $1,385 2172%
Self Pay - Mcd Pending 100 Percent $1,309 - $1,385 2172%
Single Case Agreement $1,309 - $1,385 2172%
United Behavioral Health Psych $1,309 - $1,385 2172%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals