CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Warner Hospital and Health Services

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $253
Cash Discount Price: $321
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Warner Hospital and Health Services is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.20x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

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: $321 (533%)

Insurance Median: $253 (420%)

Cash: $321 (533% of Medicare)

Ins. Median: $253 (420% 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 420% of the Medicare baseline (a markup of 320%). 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	$98 - $292	163%
Blue Cross Blue Shield	$98 - $336	163%
Harmony Hp Mcaid-All Plans	$98	163%
Medicaid / KanCare	$98	163%
Meridian Hp-All Plans	$98	163%
Molina-All Other Plans	$98	163%
Health Alliance Med Adv	$122 - $141	202%
Humana	$122 - $292	202%
Molina Mcr/Mcd Dual	$122 - $141	202%
UnitedHealthcare	$122 - $292	202%
Wellcare Mcr Adv-All Plans	$122 - $141	202%
Healthlink Hmo	$232 - $268	385%
City Of Clinton (Employees Serv)-All Plans	$238 - $275	395%
Cigna	$247 - $285	410%
Caterpillar-All Plans	$253 - $292	420%
Multiplan Phcs-All Plans	$253 - $292	420%
Health Alliance-All Other Plans	$262 - $302	435%
Healthlink Ppo/Work Comp-All Other Plans	$262 - $302	435%
Consociate Care Ppo-All Plans	$268 - $309	445%
Hfn Ppo/Epo-All Plans	$268 - $309	445%
Three Rivers-All Plans	$283 - $326	470%

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 $321.
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 Warner Hospital and Health Services 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.