CMS Price Transparency Data
Electrocardiogram (EKG, tracing only)
Facility: Trinity Health Oakland Hospital
Billing Code: 93005 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93005
- Insurance Median: $173
- Cash Discount Price: $13,449
- vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Trinity Health Oakland Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,449. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.87x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$13,449
Average discount available for prompt cash payment at this facility.
Insurance Median
$173
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: $13,449 (22315%)
Insurance Median: $173 (287%)
Cash: $13,449 (22315% of Medicare)
Ins. Median: $173 (287% 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 287% of the Medicare baseline (a markup of 187%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Blue Cross Blue Shield | $11 - $17,056 | 18% |
| U Of M Health Plan | $14 | 23% |
| Bcn Domestic | $17 - $27,675 | 28% |
| Blue Benefit Administrators Of Massachusetts | $17 - $14,295 | 28% |
| Blue Care Network | $17 - $27,675 | 28% |
| Blue Distinction Transplant | $17 - $14,295 | 28% |
| Blue Shield - Ca | $17 - $14,295 | 28% |
| Blue Shield - Id (Regence) | $17 - $14,295 | 28% |
| Blue Shield - Ny Highmark Northeastern | $17 - $14,295 | 28% |
| Blue Shield - Ny Highmark Western | $17 - $14,295 | 28% |
| Blue Shield - Pa (Highmark) | $17 - $14,295 | 28% |
| Blue Shield - Wa (Regence) | $17 - $14,295 | 28% |
| Health Choices | $17 - $14,295 | 28% |
| Kaiser Domestic | $17 - $14,295 | 28% |
| Asr Health Benefits | $26 | 43% |
| Caresource | $26 | 43% |
| Hap | $26 - $179 | 43% |
| Varipro | $26 | 43% |
| Medicaid / KanCare | $32 - $5,838 | 53% |
| Priority Health | $34 - $15,361 | 56% |
| Aetna | $58 - $10,206 | 96% |
| Blue Care Network Advantage | $58 - $10,206 | 96% |
| Medicare (plans) | $58 - $10,414 | 96% |
| Align Senior Care | $59 - $10,414 | 98% |
| Hospice Advantage | $59 - $10,414 | 98% |
| UnitedHealthcare | $61 - $10,727 | 101% |
| Cca - Zing Health | $62 - $11,023 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $66 - $11,737 | 110% |
| Wc Accident Fund | $75 | 124% |
| Wc Advantage | $75 | 124% |
| Wc Aig | $75 | 124% |
| Wc Allied | $75 | 124% |
| Wc Amerisure | $75 | 124% |
| Wc Amtrust | $75 | 124% |
| Wc Asu Risk Mgt | $75 | 124% |
| Wc Berkley Admin | $75 | 124% |
| Wc Broadspire | $75 | 124% |
| Wc Bunch & Associates | $75 | 124% |
| Wc Ccmsi | $75 | 124% |
| Wc Emc Insurance Company | $75 | 124% |
| Wc Esis | $75 | 124% |
| Wc Fcci | $75 | 124% |
| Wc Federated | $75 | 124% |
| Wc Gallagher Bassett | $75 | 124% |
| Wc Genex Care For Ohio | $75 | 124% |
| Wc Guard Insurance Company | $75 | 124% |
| Wc Hartford | $75 | 124% |
| Wc Liberty Mutual | $75 | 124% |
| Wc Meijers | $75 | 124% |
| Wc Michigan | $75 | 124% |
| Wc Mitchell Frankenmuth | $75 | 124% |
| Wc Pma | $75 | 124% |
| Wc Sedgwick | $75 | 124% |
| Wc Sentry | $75 | 124% |
| Wc Travelers | $75 | 124% |
| Wc Tristar | $75 | 124% |
| Wc Walmart | $75 | 124% |
| Wc Zurich | $75 | 124% |
| Molina Marketplace | $76 - $13,539 | 126% |
| Health Cost Solutions | $91 - $16,142 | 151% |
| Vitalcore | $91 - $16,142 | 151% |
| Wellpath | $91 - $16,142 | 151% |
| Acs Benefit Services | $108 | 179% |
| Allied Benefit Systems | $108 | 179% |
| Claimchoice Adminstrators | $108 | 179% |
| Consociate | $108 | 179% |
| Cypress Benefit Administrators | $108 | 179% |
| Forest County Potawatomi | $108 | 179% |
| Health Smart | $108 | 179% |
| Healthgram | $108 | 179% |
| Healthscope | $108 | 179% |
| Secureone Preferred United Plans | $108 | 179% |
| Sisco Benefits | $108 | 179% |
| The Health Plan | $108 | 179% |
| Trustmark Small Business Benefits | $108 | 179% |
| Unified Group Services | $108 | 179% |
| Webtpa | $108 | 179% |
| Mclaren Health | $118 - $129 | 196% |
| Carelon Behavioral Health | $123 | 204% |
| Employee Benefit Logistic | $136 - $24,027 | 226% |
| Magellan Behavioral Health | $148 | 246% |
| Geha | $154 - $184 | 256% |
| Medical Mutual | $154 | 256% |
| Meritain | $154 | 256% |
| 1199 National Benefit Fund | $167 | 277% |
| Allied National Global Care | $167 | 277% |
| Asrm - Reliance Standard Life Insurance | $167 | 277% |
| Christian Care Ministry | $167 | 277% |
| Dean Health | $167 | 277% |
| Fallon Health | $167 | 277% |
| Family Life Insurance Company | $167 | 277% |
| Ghc Scw | $167 | 277% |
| Group Pension Administrators | $167 | 277% |
| International Benefit Administrators | $167 | 277% |
| Lifetime Benefit Solutions | $167 | 277% |
| Manhattan Life | $167 | 277% |
| Medi Share | $167 | 277% |
| Multiplan | $167 | 277% |
| Mvp | $167 | 277% |
| Pai | $167 | 277% |
| Pan-American Life | $167 | 277% |
| Paramount Hmo | $167 | 277% |
| Phcs | $167 | 277% |
| Trinity Health Share | $167 | 277% |
| Health Partners | $179 | 297% |
| Tufts Health Plan | $179 | 297% |
| Access Health | $181 | 300% |
| Acclaim | $181 | 300% |
| Administrative Concepts | $181 | 300% |
| Allegeant | $181 | 300% |
| Ameriben | $181 | 300% |
| American Family | $181 | 300% |
| American Healthcare Alliance | $181 | 300% |
| American National | $181 | 300% |
| American Republic | $181 | 300% |
| Amerihealth | $181 | 300% |
| Aultcare | $181 | 300% |
| Automated Benefit Services | $181 | 300% |
| Auxiant | $181 | 300% |
| Benefit Administrative Systems,Llc | $181 | 300% |
| Boon Chapman | $181 | 300% |
| Cam Administrative Services | $181 | 300% |
| Christian Brother Services | $181 | 300% |
| Christian Brothers Holy Cross | $181 | 300% |
| Comprehensive Benefits | $181 | 300% |
| Continental Life Insurance | $181 | 300% |
| Custom Benefit Administrators | $181 | 300% |
| Employee Benefit Concepts | $181 | 300% |
| Employee Benefit Management | $181 | 300% |
| Enterprise Group Planning | $181 | 300% |
| Freedom Life Insurance Company | $181 | 300% |
| Group Administrators | $181 | 300% |
| Group Marketing Services | $181 | 300% |
| Guardian | $181 | 300% |
| Health America | $181 | 300% |
| Healthcare Management Admin | $181 | 300% |
| Healthez | $181 | 300% |
| Humana | $181 | 300% |
| Insight | $181 | 300% |
| Intercare | $181 | 300% |
| Jfp Benefit Management | $181 | 300% |
| Jp Farley Corporation | $181 | 300% |
| Key Benefit Administrator | $181 | 300% |
| Liberty Union Life Assurance Co | $181 | 300% |
| Lucent Health | $181 | 300% |
| Luminare Health | $181 | 300% |
| Luminare Health (Detroit) | $181 | 300% |
| Magnacare | $181 | 300% |
| Medben | $181 | 300% |
| Medcost | $181 | 300% |
| Mutual Health Services | $181 | 300% |
| Mutual Of Omaha | $181 | 300% |
| Ncas | $181 | 300% |
| Nippon Life Ins | $181 | 300% |
| Nova | $181 | 300% |
| Painters Union Insurance Fund | $181 | 300% |
| Physicians Mutual | $181 | 300% |
| Plumbers Local 98 Insurance Fund | $181 | 300% |
| Prairie States | $181 | 300% |
| Preferred One | $181 | 300% |
| Primary Physician Care | $181 | 300% |
| Professional Benefit Administrators | $181 | 300% |
| Siho Insurance Services | $181 | 300% |
| The Loomis Company | $181 | 300% |
| Unicare | $181 | 300% |
| Us Health And Life | $181 | 300% |
| Valenz | $181 | 300% |
| Western & Southern Financial Group | $181 | 300% |
| Wps | $181 | 300% |
| Cigna | $182 | 302% |
| Coventry | $185 | 307% |
| First Health | $185 | 307% |
| Prime Health Services | $197 | 327% |
| Three Rivers Provider Network | $221 | 367% |
| Cmh Detroit Wayne Integrated Health Network | $246 | 408% |
| Cmh Lenawee County | $246 | 408% |
| Cmh Livingston County | $246 | 408% |
| Cmh Misc | $246 | 408% |
| Cmh Monroe County | $246 | 408% |
| Cmh Oakland County | $246 | 408% |
| Cmh Washtenaw County | $246 | 408% |