CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Elkhart General Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $154
Cash Discount Price: $148
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Elkhart General Hospital is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.56x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $148 (246%)

Insurance Median: $154 (256%)

Cash: $148 (246% of Medicare)

Ins. Median: $154 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Mclaren (Mi	$33	55%
UnitedHealthcare	$33 - $153	55%
Devoted Healthcare	$46 - $65	76%
Blue Cross Blue Shield	$48 - $186	80%
Aetna	$62 - $154	103%
Humana	$62 - $160	103%
Pace	$62	103%
Plain Church	$93 - $182	154%
Caresource	$100 - $296	166%
Mhs	$112 - $296	186%
Cha	$137 - $178	227%
Immergrun	$137 - $182	227%
Php	$148 - $160	246%
Cigna	$164 - $173	272%
Multiplan	$164	272%
Signature	$166	275%
Encore	$169	280%
Heartland	$228	378%
Mdwise	$296	491%

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 $148.
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 Elkhart General 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.