CMS Price Transparency Data
Electrocardiogram (EKG, tracing only)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 93005 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93005
- Insurance Median: $220
- Cash Discount Price: $778
- vs. Medicare Baseline: 3.65x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Saint Joseph Regional Medical Center - Plymouth is $220. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $778. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.65x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$778
Average discount available for prompt cash payment at this facility.
Insurance Median
$220
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: $778 (1291%)
Insurance Median: $220 (365%)
Cash: $778 (1291% of Medicare)
Ins. Median: $220 (365% 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 365% of the Medicare baseline (a markup of 265%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bureau Of Disability | $10 | 17% |
| Aetna | $32 - $268 | 53% |
| Blue Cross Blue Shield | $32 - $564 | 53% |
| Medicaid / KanCare | $32 - $564 | 53% |
| UnitedHealthcare | $32 - $564 | 53% |
| Medicare (plans) | $62 - $144 | 103% |
| Meridian Complete | $62 - $141 | 103% |
| Pace-Trinity Health | $62 - $141 | 103% |
| County Coroner | $65 - $146 | 108% |
| Provider Partners Health Plan Of Indiana | $69 - $155 | 114% |
| Auxiant | $94 - $343 | 156% |
| Physicians Health Plan Northern Indiana Health Insurance | $94 - $425 | 156% |
| St Joseph County Hlth Dpt | $94 - $211 | 156% |
| Caresource | $97 - $218 | 161% |
| Siho Insurance Services | $100 - $225 | 166% |
| Key Benefit Administrator | $112 - $303 | 186% |
| Plain Church Group | $112 | 186% |
| Allied Benefit Systems | $119 - $268 | 197% |
| Custom Design Benefits | $134 - $303 | 222% |
| Managed Health Services - Indiana | $136 - $564 | 226% |
| Mdwise | $136 - $564 | 226% |
| Blue Benefit Administrators Of Massachusetts | $220 - $497 | 365% |
| Blue Care Network | $220 - $497 | 365% |
| Blue Distinction Transplant | $220 - $497 | 365% |
| Blue Shield - Ca | $220 - $497 | 365% |
| Blue Shield - Id (Regence) | $220 - $497 | 365% |
| Blue Shield - Ny Highmark Northeastern | $220 - $497 | 365% |
| Blue Shield - Ny Highmark Western | $220 - $497 | 365% |
| Blue Shield - Pa (Highmark) | $220 - $497 | 365% |
| Blue Shield - Wa (Regence) | $220 - $497 | 365% |
| Notre Dame Athletic Association | $227 | 377% |
| Wc Notre Dame | $227 | 377% |
| Luminare Health (Detroit) | $235 - $248 | 390% |
| Ameriben | $248 | 411% |
| Geha | $263 | 436% |
| Healthscope | $263 | 436% |
| Student Insurance Cma | $263 | 436% |
| Asr Health Benefits | $268 | 445% |
| Christian Brother Services | $268 | 445% |
| Employee Benefit Management | $268 | 445% |
| Medical Mutual | $268 | 445% |
| Meritain | $268 | 445% |
| Preferred One | $268 | 445% |
| Rural Carrier Health Benefit Plan | $268 | 445% |
| Webtpa | $268 | 445% |
| Encore Health | $290 | 481% |
| Indiana Criminal Justice Inst | $290 | 481% |
| Western & Southern Financial Group | $290 | 481% |
| Cigna | $297 | 493% |
| Group Administrators | $297 | 493% |
| Health Partners | $297 | 493% |
| Mvp | $297 | 493% |
| Prairie States | $297 | 493% |
| Priority Health | $297 | 493% |
| Professional Benefit Administrators | $297 | 493% |
| Sagamore Health Network | $297 - $318 | 493% |
| Sisco Benefits | $297 | 493% |
| Unified Group Services | $297 | 493% |
| Goshen Preferred Network | $318 - $355 | 528% |
| Signature Care | $343 | 569% |
| Allied National Global Care | $372 | 617% |
| Asrm - Reliance Standard Life Insurance | $372 | 617% |
| Avmed Health Plan | $372 | 617% |
| Christian Care Ministry | $372 | 617% |
| Dean Health | $372 | 617% |
| Fallon Health | $372 | 617% |
| Family Life Insurance Company | $372 | 617% |
| Freedom Life Insurance Company | $372 | 617% |
| Ghc Scw | $372 | 617% |
| International Benefit Administrators | $372 | 617% |
| Lifetime Benefit Solutions | $372 | 617% |
| Manhattan Life | $372 | 617% |
| Medi Share | $372 | 617% |
| Multiplan | $372 | 617% |
| Pai | $372 | 617% |
| Pan-American Life | $372 | 617% |
| Paramount Hmo | $372 | 617% |
| Phcs | $372 | 617% |
| Philadelphia American Life Insurance | $372 | 617% |
| Trinity Health Share | $372 | 617% |
| Bankers Life Casualty | $413 | 685% |
| Wc Align Network | $413 | 685% |