CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: South Miami Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $155
Cash Discount Price: $337
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at South Miami Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $337. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.57x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$337

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $337 (559%)

Insurance Median: $155 (257%)

Cash: $337 (559% of Medicare)

Ins. Median: $155 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Amerigroup	$8 - $16	13%
Medicaid / KanCare	$8 - $18	13%
Sunshine State	$8 - $17	13%
UnitedHealthcare	$8 - $629	13%
Wellcare	$8 - $17	13%
Aetna	$9 - $503	15%
Vista	$9 - $17	15%
Blue Cross Blue Shield	$26 - $408	43%
Avmed	$27 - $311	45%
Humana	$27 - $67	45%
Cigna	$28 - $503	46%
Medicare (plans)	$31 - $83	51%
Medica Health Plan	$33 - $66	55%
Leon Medical	$34 - $68	56%
Non Contracted	$150 - $231	249%
Amerihealth	$184 - $283	305%
International	$266 - $409	441%
Dimension Health Plan	$307 - $566	509%
Affordable	$348 - $535	577%
Phcs	$368 - $566	611%
Quality Health	$368 - $566	611%

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 $337.
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 South Miami 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.