CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Palos Community Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $200
Cash Discount Price: $200
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Palos Community Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.32x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $200 (332%)

Insurance Median: $200 (332%)

Cash: $200 (332% of Medicare)

Ins. Median: $200 (332% 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 332% of the Medicare baseline (a markup of 232%). 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
Blue Cross Blue Shield	$46 - $285	76%
Cigna	$53 - $285	88%
Aetna	$61 - $285	101%
Carelon Behavioral Health [159]	$142	236%
Healthlink [125]	$142 - $285	236%
First Health Plan [6034]	$162 - $214	269%
Magellan Behavioral Hlth [136]	$171	284%
The Alliance [1703]	$183	304%
Multiplan/Phcs [142]	$200 - $285	332%
Compsych [112]	$214	355%
Beechstreet [176]	$228	378%
Health'S Finest Network [126]	$242	402%
Galaxy Health Network [220]	$285	473%
Global Excel [1712]	$285	473%
Health Alliance [181]	$285	473%
UnitedHealthcare	$285	473%

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 $200.
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 Palos Community 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.