CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $116
Cash Discount Price: $256
vs. Medicare Baseline: 1.92x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Cleveland Clinic Indian River Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.92x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $256 (425%)

Insurance Median: $116 (192%)

Cash: $256 (425% of Medicare)

Ins. Median: $116 (192% 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
Clear Spring Health	$9	15%
Aetna	$60 - $315	100%
Blue Cross Blue Shield	$60 - $408	100%
Carelon Bh Strategies	$60	100%
Careplus	$60	100%
Freedom Health	$60	100%
Humana	$60	100%
United	$60 - $256	100%
Wellcare	$60	100%
Wellmed	$60	100%
Avmed	$62 - $137	103%
Independent Living Systems	$63	105%
Devoted Health	$66	110%
Cigna	$95 - $118	158%
Bmi	$217	360%
Magellan	$236	392%
Clarity Health	$256	425%
The Legacy Companies	$256	425%
Multiplan	$315	523%

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 $256.
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 Cleveland Clinic Indian River Hospital 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.