CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Decatur Memorial Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $164
Cash Discount Price: $357
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Decatur Memorial Hospital is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $357. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.72x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$357

Average discount available for prompt cash payment at this facility.

Insurance Median

$164

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: $357 (592%)

Insurance Median: $164 (272%)

Cash: $357 (592% of Medicare)

Ins. Median: $164 (272% 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 272% of the Medicare baseline (a markup of 172%). 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	$7 - $240	12%
Blue Cross Blue Shield	$7 - $357	12%
Coventry	$7 - $214	12%
Health Alliance	$7 - $237	12%
Humana	$7 - $232	12%
Medicare (plans)	$7 - $62	12%
Tricare	$7 - $63	12%
UnitedHealthcare	$7 - $357	12%
Veterans Administration	$7 - $62	12%
Medicaid / KanCare	$32 - $33	53%
Illinois Workers Compensation	$60 - $190	100%
Wellcare	$62	103%
Caterpillar	$142	236%
Mennonite Churches	$154	256%
Plain Church Medical Group	$161	267%
Health Alliance Mh Employee Plan	$164	272%
Cigna	$166	275%
Hfn	$179 - $268	297%
Commercial Workers Compensation	$180	299%
6 Degrees Health	$214	355%
Hopetrust	$214	355%
Hst	$214	355%
Phcs Savility	$232	385%
Phcs Multiplan Ppo	$243	403%
Healthlink	$245	407%
Corvel	$257	426%
Consociate	$264	438%
Liability	$357	592%

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 $357.
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 Decatur 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.