CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Northside Hospital Duluth

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $303
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 5.03x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Northside Hospital Duluth is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 5.03x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$303

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: $407 (675%)
Insurance Median: $303 (503%)
Cash: $407 (675% of Medicare)
Ins. Median: $303 (503% 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 503% of the Medicare baseline (a markup of 403%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Champus Va $6 10%
Mti $10 17%
One Call Diagnostics $10 17%
Homelink $11 18%
Us Dept Of Labor Wc $12 20%
Blue Cross Blue Shield $58 - $378 96%
Clear Springs Eon Health $58 96%
Medicare (plans) $58 - $70 96%
UnitedHealthcare $58 - $383 96%
Va Ccn $58 96%
Aetna $59 - $369 98%
Bccp $59 98%
Cbww $59 98%
Coventry $59 - $369 98%
Humana $59 - $61 98%
Caresource $60 - $202 100%
Kaiser $60 - $472 100%
Tricare $60 100%
Wellcare $60 100%
Clover Health $61 101%
Pruitt Health Premier $61 101%
Fairly Group $67 111%
Ambetter / Centene $68 - $255 113%
Amerigroup $68 - $97 113%
Institutional Gwinnett County Govt $68 - $97 113%
Medicaid / KanCare $68 - $112 113%
Lantern $73 121%
Cigna $82 - $341 136%
Truths Community $116 192%
Genex/Priority Care Solutions $124 206%
Spreemo $124 206%
Authentic 4D $140 232%
Streamline Imaging $140 232%
Corvel Workers Comp $148 246%
Employers Choice Network $148 246%
Fieldale Farms Wc $156 259%
Georgia Workers Compensation $156 259%
Georgia Reproductive Specialists $217 360%
Medlien Healthcare Services $217 360%
Med Care Solutions $244 405%
Oscar $255 423%
Health One Alliance_Ppo $298 494%
Quick Trip $298 494%
Northside Health Network $336 557%
Novanet_Ppo $379 629%
Phcs $406 674%
Beech Steet $461 765%
Multiplan $461 765%
Multiplan Workers Comp $461 765%
Careiq $542 899%
Dekalb_Department Of Health $542 899%
Fifa $542 899%
Institutional Marietta Surgery Center $542 899%
Institutional Veterans Evaluation Services $542 899%
Johnson Ferry Imaging $542 899%
Marietta Dermatology Clinical Research Inc $542 899%
Rabun County Boc $542 899%
West Paces Imaging Agreement $542 899%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals