CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Carle Foundation Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $139
Cash Discount Price: $462
vs. Medicare Baseline: 2.31x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Carle Foundation Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $462. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.31x the Medicare baseline. Located in 611 West Park Street, Urbana, IL.

Cash / Self-Pay

$462

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $462 (767%)

Insurance Median: $139 (231%)

Cash: $462 (767% of Medicare)

Ins. Median: $139 (231% 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 231% of the Medicare baseline (a markup of 131%). 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
Humana	$6 - $63	10%
Aetna	$7 - $371	12%
Meridian	$46 - $63	76%
Blue Cross Blue Shield	$63 - $300	105%
Molina	$63 - $139	105%
UnitedHealthcare	$63 - $286	105%
Wellcare	$63	105%
Community Partners Health Plan (Cphp)	$272	451%
Cigna	$360	597%
Multiplan/Phcs	$370	614%
Healthlink	$393	652%

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 $462.
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 Carle Foundation 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.