CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $249
  • Cash Discount Price: $278
  • vs. Medicare Baseline: 4.13x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at HSHS St Elizabeth's Hospital is $249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.13x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$278

Average discount available for prompt cash payment at this facility.

Insurance Median
$249

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: $278 (461%)
Insurance Median: $249 (413%)
Cash: $278 (461% of Medicare)
Ins. Median: $249 (413% 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 413% of the Medicare baseline (a markup of 313%). 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.

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
Molina Healthcare $23 - $69 38%
Aetna $25 - $272 41%
Blue Cross Blue Shield $25 - $386 41%
Claim Doc $25 - $166 41%
Clear Spring Health Of Illinois $25 - $66 41%
Health Alliance Medical Plans $25 - $328 41%
Health Partners $25 - $66 41%
Hopetrust $25 - $159 41%
Humana $25 - $66 41%
Meridian Health Plan $25 41%
Naphcare $25 - $144 41%
Sae Hospice $25 - $66 41%
UnitedHealthcare $25 - $386 41%
Amish Community $108 179%
Celtic Insurance Company $133 221%
Wellfirst $249 413%
First Health $287 476%
Cigna $305 - $386 506%
Healthlink $307 - $386 509%
Caterpillar, Inc. $310 514%
Consociate Group $340 564%
Choicecare $347 576%
Healthcare Finest Network (Hfn) $347 576%
Multiplan/Phcs $347 576%
Provider Network Of America $347 576%
City Of Springfield $386 640%
Current Health Solutions $386 640%
Healthscope $386 640%
Illinois Breast And Cervical Cancer Program $386 640%
Interplan $386 640%
Live360 $386 640%
Wexford $386 640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals