CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Alton Memorial Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $327
Cash Discount Price: $318
vs. Medicare Baseline: 5.43x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Alton Memorial Hospital is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $318. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 5.43x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$318

Average discount available for prompt cash payment at this facility.

Insurance Median

$327

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: $318 (528%)

Insurance Median: $327 (543%)

Cash: $318 (528% of Medicare)

Ins. Median: $327 (543% 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 543% of the Medicare baseline (a markup of 443%). 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
Aetna	$63 - $398	105%
Blue Cross Blue Shield	$63 - $461	105%
Humana	$63 - $295	105%
UnitedHealthcare	$63 - $394	105%
Essence Healthcare [221]	$65	108%
Cox Health [757]	$66	110%
Devoted Health Plan [847]	$66	110%
Medica [662]	$66	110%
Allied Benefits [498]	$216 - $394	358%
Coresource [497]	$216	358%
Fmh Benefit Service Inc [222]	$216	358%
Mail Handlers [495]	$216	358%
Consociate [478]	$230	382%
Sarah Bush Lincoln [636]	$230	382%
Cigna	$245 - $424	407%
Healthlink [225]	$257 - $400	426%
Healthscope Benefits [258]	$260	431%
Cox Health Systems Insurance Company [220]	$292 - $344	484%
Health Alliance [224]	$292	484%
Hope Trust [806]	$307	509%
Apwu Health Plan [216]	$327	543%
Nalc Health Benefit Plan [242]	$327	543%
Priority Health [648]	$327	543%
Med-Pay [480]	$344 - $398	571%
Unicare [568]	$344 - $400	571%
First Health Commercial [734]	$394	654%
Beechstreet [551]	$398	660%
Detego Health [868]	$398	660%
Health Systems Inc [620]	$398	660%
Healthcare Sol Mercy [609]	$398	660%
Multiplan Commercial [737]	$398	660%
Multiplan [240]	$398	660%
Phcs [244]	$398 - $424	660%
Preferred Health Professionals [561]	$400	664%
Hfn [563]	$424	704%
Medica [661]	$424	704%

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 $318.
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 Alton Memorial 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.