CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $180
Cash Discount Price: $622
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Central Florida Lake Monroe Hospital is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $622. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.99x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$622

Average discount available for prompt cash payment at this facility.

Insurance Median

$180

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: $622 (1032%)

Insurance Median: $180 (299%)

Cash: $622 (1032% of Medicare)

Ins. Median: $180 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Freedom Health	$7 - $115	12%
Optimum	$7 - $115	12%
Corvel Corporation	$15 - $248	25%
Careworks (Rockport Community)	$16 - $261	27%
Oscar	$16 - $256	27%
Prime Health	$16 - $253	27%
Simply	$16 - $246	27%
Simply Healthcare	$17 - $267	28%
Cigna	$18 - $278	30%
Molina Healthcare	$19 - $511	32%
Humana	$20 - $320	33%
Evolutions	$23 - $367	38%
Avmed	$24 - $799	40%
Sunshine State Health Plan	$26 - $10,254	43%
Aetna	$30 - $479	50%
United	$34 - $719	56%
Florida Health Care Plan	$38 - $602	63%
Plotkin Health	$51 - $799	85%
Prime Health Sheriff	$51 - $799	85%
Multiplan	$76 - $1,358	126%
Three Rivers Provider Network	$76 - $1,198	126%
Ppo Next	$86 - $1,358	143%
Novanet	$91 - $1,438	151%

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 $622.
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 Central Florida Lake Monroe 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.