CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Merit Health River Oaks

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $224
  • Cash Discount Price: $451
  • vs. Medicare Baseline: 3.72x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Merit Health River Oaks is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.72x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$451

Average discount available for prompt cash payment at this facility.

Insurance Median
$224

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: $451 (748%)
Insurance Median: $224 (372%)
Cash: $451 (748% of Medicare)
Ins. Median: $224 (372% 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 372% of the Medicare baseline (a markup of 272%). 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.

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
Medicaid / KanCare $45 - $306 75%
UnitedHealthcare $45 - $536 75%
Caresource Truecare $46 76%
Magnolia Mcd Chip $46 76%
Molina Chip $49 81%
Tricare $51 85%
Humana $52 86%
Medicare (plans) $52 86%
Node First Choice Shared Health Of Ms Mcr Adv $52 86%
Node Vantage Health Mcr Adv $52 86%
Molina $53 88%
Node Champva $53 88%
Node Devoted Health Mcr Adv $53 88%
Node First Choice American Health Mcr Adv $53 88%
Node Hospice Non Par Agree $53 88%
Node Va $53 88%
Aetna $54 - $1,404 90%
Node First Choice Wellcare Mcr Adv $54 90%
Node Healthy Mississippi Mcr Adv $59 98%
Veterans Eval Services $59 98%
Node Us Dept Of Labor $67 111%
First Choice Preferred $80 133%
Node First Choice Occunet $80 133%
Ms Work Comp $81 134%
Prime Health Wc $81 134%
Molina Exchange $87 144%
Node First Choice Seven Corners $91 151%
Advanced Health Systems $93 154%
Magnolia Exchange $93 154%
First Choice Lgp $116 192%
Vantage Health Commercial $120 199%
Blue Cross Blue Shield $130 216%
Cigna $399 662%
Self Pay $441 732%
Trimed Billing Solutions $602 999%
Ms State Hospital Of Whitfield Ms $762 1264%
First Choice Standard $923 1531%
First Choice Coventry $1,043 1731%
First Choice Mpcn Standard $1,103 1830%
First Choice Ppo Plus $1,103 1830%
Phcs $1,204 1998%
Benefit Administration Services $1,444 - $1,705 2396%
Benefit Management Systems $1,444 - $1,705 2396%
Citizens State Bank Inc $1,444 - $1,705 2396%
First Choice Stratose $1,605 2663%
Prime Health Services $1,605 2663%
American Health Group $1,705 2829%
Beech Street $1,705 2829%
Formost $1,705 2829%
Usa Mco $1,705 2829%
One Health Plan $1,805 2995%
Ms Dept Of Rehabilitation Services $2,006 3328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals