CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Salem Memorial District Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $103
  • Cash Discount Price: $139
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Salem Memorial District Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.71x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$139

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $139 (231%)
Insurance Median: $103 (171%)
Cash: $139 (231% of Medicare)
Ins. Median: $103 (171% 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.

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 $39 - $232 65%
Ambetter / Centene $39 - $87 65%
Blue Cross Blue Shield $39 - $244 65%
Humana $39 - $219 65%
Tricare $39 - $87 65%
Triwest $39 - $87 65%
UnitedHealthcare $39 - $104 65%
Veteran'S Affairs $39 - $87 65%
Healthlink $74 - $167 123%
First Health $91 - $206 151%
Mercy - C.B. Management Company/Joplin Supply Company $91 - $206 151%
Mercy - City Of Springfield $91 - $206 151%
Mercy - Clayco $91 - $206 151%
Mercy - Commerce Bank $91 - $206 151%
Mercy - Diversified Plastics $91 - $206 151%
Mercy - Employers Benefit Alliance $91 - $206 151%
Mercy - Evolutions $91 - $206 151%
Mercy - Fabick Cat $91 - $206 151%
Mercy - Firsthealth Network $91 - $206 151%
Mercy - Health Management Network $91 - $206 151%
Mercy - Health Systems Inc $91 - $206 151%
Mercy - Liberty Utilities/Empire District Electric $91 - $206 151%
Mercy - Life Church $91 - $206 151%
Mercy - Missouri State University $91 - $206 151%
Mercy - Prime Health Services $91 - $206 151%
Mercy - Quiktrip Corporation $91 - $206 151%
Mercy - Shinesolar $91 - $206 151%
Mercy - Springfield Public Schools $91 - $206 151%
Mercy - Springfield Remanufacturing $91 - $206 151%
Mercy - Sumnerone $91 - $206 151%
Mercy - Trailiner $91 - $206 151%
Mercy - Walmart Mercy Accountable Care Plan $91 - $206 151%
Mercy-American Healthcare Alliance $91 - $206 151%
Phcs $91 - $219 151%
Cigna $97 - $218 161%
Mercy - Compresults $103 - $232 171%
Mercy - Corvel Corporation $103 - $232 171%
Mercy - Novasys $103 - $232 171%
Mercy - Scurlock Industries $103 - $232 171%
Mercy - Usa Managed Care Organization $103 - $232 171%
Right Choice-Alliance $108 - $244 179%
Right Choice-Regular $111 - $250 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals