CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Kirby Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $143
Cash Discount Price: $276
vs. Medicare Baseline: 2.37x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Kirby Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.37x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.

Cash / Self-Pay

$276

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $276 (458%)

Insurance Median: $143 (237%)

Cash: $276 (458% of Medicare)

Ins. Median: $143 (237% 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 237% of the Medicare baseline (a markup of 137%). 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	$5 - $451	8%
Aetna	$7 - $322	12%
Meridian	$7 - $143	12%
Molina	$7 - $147	12%
UnitedHealthcare	$7 - $317	12%
Wellcare	$7 - $143	12%
Humana	$8 - $345	13%
Zelis (Hfn)	$8 - $414	13%
Catepillar, Inc.	$9 - $391	15%
Cigna	$368	611%
Healthlink	$414	687%
Multiplan/Phcs	$437	725%

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 $276.
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 Kirby Medical Center 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.