CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Methodist Hospitals Inc

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $147
Cash Discount Price: $269
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Methodist Hospitals Inc is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.44x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$269

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $269 (446%)

Insurance Median: $147 (244%)

Cash: $269 (446% of Medicare)

Ins. Median: $147 (244% 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 244% of the Medicare baseline (a markup of 144%). 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	$12 - $284	20%
Magnacare	$30	50%
Blue Cross Blue Shield	$62 - $415	103%
Humana	$62 - $136	103%
Medicare (plans)	$62	103%
United Heathcare	$62	103%
Zing	$63	105%
Caresource Maketplace	$102	169%
Ambetter / Centene	$124	206%
Caresource	$136	226%
Managed Health Services	$136	226%
Medicaid / KanCare	$136	226%
UnitedHealthcare	$136 - $172	226%
Cigna	$147 - $160	244%
Physicians Health Plan Of Northern Indiana	$222	368%
Encore	$230 - $342	382%
Phcs	$261	433%
Siho	$269	446%
Sagamore	$276	458%
Multiplan	$280	465%
Hfn	$300 - $326	498%

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 $269.
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 Methodist Hospitals Inc 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.