CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Sanford Hillsboro

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $183
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 3.04x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Sanford Hillsboro is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.04x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $178 (295%)
Insurance Median: $183 (304%)
Cash: $178 (295% of Medicare)
Ins. Median: $183 (304% 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 304% of the Medicare baseline (a markup of 204%). 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
Blue Cross Blue Shield $80 - $160 133%
Sanford Health Plan Align $101 168%
Ucare $109 - $195 181%
Aetna $110 - $193 183%
Health Partners $110 - $173 183%
Medicare (plans) $110 183%
UnitedHealthcare $110 - $185 183%
Primewest $112 186%
Security Health Plan $122 202%
Sanford Health Plan $175 - $206 290%
Medica $183 - $196 304%
First Choice Health Network $200 332%
Healthez $200 332%
Multiplan $200 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 Third Street Se, Hillsboro, ND 58045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals