CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: St Mary's General Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $100
Cash Discount Price: $69
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at St Mary's General Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.66x the Medicare baseline. Located in 350 Boulevard, Passaic, NJ.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $69 (114%)

Insurance Median: $100 (166%)

Cash: $69 (114% of Medicare)

Ins. Median: $100 (166% 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.

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
Humana	$56	93%
Aetna	$70 - $148	116%
Amerihealth	$70	116%
Clover Health	$70	116%
Horizon	$70 - $124	116%
Medicare (plans)	$70	116%
Tricare	$70	116%
UnitedHealthcare	$70 - $293	116%
Wellcare	$70 - $94	116%
Wellpoint Amerigroup	$70	116%
Ally-Align (Fka Spartan Plan Nj, Inc.)	$73	121%
Employer Direct Healthcare	$98	163%
Cigna	$102	169%
Fairprice Healthcare Holdings	$112	186%
Coventry	$139	231%

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 $69.
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 Mary's General 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.