CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Lexington Memorial Hospital Inc

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $129
Cash Discount Price: $146
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Lexington Memorial Hospital Inc is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.14x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $146 (242%)

Insurance Median: $129 (214%)

Cash: $146 (242% of Medicare)

Ins. Median: $129 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Amerihealth	$55 - $80	91%
Carolina Complete	$55	91%
Healthy Blue	$55	91%
Partners	$55	91%
Alliance	$56	93%
UnitedHealthcare	$56 - $131	93%
Vaya	$56	93%
Wellcare	$56	93%
Trillium	$57	95%
Medcost	$64 - $195	106%
Blue Cross Blue Shield	$80 - $128	133%
Aetna	$83 - $270	138%
Ambetter / Centene	$84	139%
Oscar	$93 - $128	154%
Cigna	$127 - $129	211%
Directnet	$173	287%
Healthgram Lexington Home Brands	$210	348%
Healthgram	$234	388%
Private Healthcare Systems	$239	397%
Beechstreet	$257	426%
Humana	$257	426%
Multiplan	$263	436%
National Provider Network	$263	436%

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 $146.
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 Lexington Memorial Hospital Inc 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.