CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $114
Cash Discount Price: $156
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Munson Healthcare Otsego Memorial Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.89x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $156 (259%)

Insurance Median: $114 (189%)

Cash: $156 (259% of Medicare)

Ins. Median: $114 (189% 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.

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
Blue Care Network	$6 - $59	10%
Hap (Health Alliance Plan)	$6 - $150	10%
Humana	$6 - $59	10%
Mclaren Health Plan	$6 - $157	10%
Medicare (plans)	$6 - $59	10%
Michigan Amish Medical Board	$6 - $59	10%
Northern Michigan Mennonite Group	$6 - $59	10%
Priority Health	$6 - $59	10%
UnitedHealthcare	$6 - $150	10%
Aetna	$7 - $151	12%
Molina	$7 - $63	12%
Blue Cross Blue Shield	$8 - $117	13%
Cigna	$9 - $20	15%
Asr Physicians Care Network	$10 - $150	17%
Nomi Health	$10 - $150	17%
Employee Benefit Logistics	$11 - $100	18%
Meridian	$31	51%
Hospice Of Michigan	$107 - $112	178%
Munson Hospice	$125 - $852	207%
Enterprise Group Planning/Employee Benefit Plan	$143 - $150	237%
Cofinity	$152 - $159	252%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$152 - $159	252%
Three Rivers Provider Network	$152 - $159	252%

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 $156.
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 Munson Healthcare Otsego Memorial 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.