CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: St Louis Childrens Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $267
Cash Discount Price: $227
vs. Medicare Baseline: 4.43x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at St Louis Childrens Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.43x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $227 (377%)

Insurance Median: $267 (443%)

Cash: $227 (377% of Medicare)

Ins. Median: $267 (443% 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 443% of the Medicare baseline (a markup of 343%). 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
Aetna	$58 - $299	96%
Blue Cross Blue Shield	$58 - $321	96%
Essence Healthcare [221]	$58	96%
Humana	$58 - $282	96%
UnitedHealthcare	$58 - $281	96%
Cox Health [757]	$61	101%
Medica [662]	$61	101%
Healthlink [225]	$183 - $285	304%
Cigna	$187 - $205	310%
Apwu Health Plan [216]	$205	340%
Consociate [478]	$205	340%
Nalc Health Benefit Plan [242]	$205	340%
Priority Health [648]	$205	340%
Sarah Bush Lincoln [636]	$205	340%
Cox Health Systems Insurance Company [220]	$208 - $280	345%
Allied Benefits [498]	$219 - $299	363%
Hope Trust [806]	$219	363%
Healthscope Benefits [258]	$231 - $302	383%
Med-Pay [480]	$246 - $284	408%
Unicare [568]	$246 - $285	408%
Health Alliance [224]	$265	440%
First Health Commercial [734]	$281	466%
Beechstreet [551]	$284	471%
Detego Health [868]	$284	471%
Health Systems Inc [620]	$284	471%
Healthcare Sol Mercy [609]	$284	471%
Multiplan Commercial [737]	$284	471%
Multiplan [240]	$284	471%
Phcs [244]	$284 - $302	471%
Preferred Health Professionals [561]	$285	473%
Coresource [497]	$299	496%
Fmh Benefit Service Inc [222]	$299	496%
Mail Handlers [495]	$299	496%
Medica [661]	$302	501%
Hfn [563]	$321	533%

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 $227.
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 St Louis Childrens 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.