CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Anderson Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $250
Cash Discount Price: $235
vs. Medicare Baseline: 4.15x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Anderson Hospital is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.15x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$235

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $235 (390%)

Insurance Median: $250 (415%)

Cash: $235 (390% of Medicare)

Ins. Median: $250 (415% 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 415% of the Medicare baseline (a markup of 315%). 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
Tricare	$6 - $5,682	10%
Humana	$7 - $4,761	12%
Medicare (plans)	$7 - $4,761	12%
UnitedHealthcare	$7 - $4,761	12%
Health Care Service Corporation	$8 - $215	13%
Medicaid / KanCare	$11 - $32	18%
Work Comp	$49 - $26,600	81%
Aetna	$62 - $4,761	103%
Devoted Health Ppo	$63 - $4,856	105%
Essence	$63 - $5,004	105%
Clear Springs Health	$64 - $4,904	106%
Ambetter / Centene	$92 - $7,044	153%
Blue Choice	$92 - $7,044	153%
Hopetrust	$158 - $12,145	262%
Self Pay	$235 - $25,000	390%
Blue Cross Blue Shield	$252 - $261	418%
Healthlink	$292 - $329	484%
Cigna	$306	508%
Mercy Aco	$306	508%
Mercy Benefit Admin	$306	508%
Multiplan/Phcs	$353	586%
Beech Street Corporation	$423	702%

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 $235.
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 Anderson 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.