CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Highland Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $13
Cash Discount Price: $208
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Highland Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 0.22x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$208

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $208 (345%)

Insurance Median: $13 (22%)

Cash: $208 (345% of Medicare)

Ins. Median: $13 (22% 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
Aetna	$5 - $91	8%
Excellus Bc/Bs [2201]	$5 - $11	8%
Medicaid / KanCare	$5 - $17	8%
Medicare (plans)	$5 - $97	8%
Elderplan [1316]	$6	10%
Humana	$6 - $90	10%
Icircle [1728]	$6	10%
Martins Point [1205]	$6 - $74	10%
Nascentia [1729]	$6	10%
UnitedHealthcare	$6 - $77	10%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$7 - $20	12%
Fidelis [5155]	$7 - $17	12%
Highmark Bc/Bs Of Western Ny [5143]	$7 - $9	12%
Amerigroup (Bswny Alternate) [1720]	$8	13%
Excellus [2201]	$8	13%
Molina Healthcare [5189], Molina Healthcare [1723]	$8	13%
Mvp [2900]	$9 - $198	15%
Independent Health [5156]	$12 - $14	20%
Cigna	$14 - $219	23%
Capital District Physicians Health Plan (Cdphp) [5149]	$15 - $20	25%
Blue Cross Blue Shield	$74 - $105	123%

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 $208.
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 Highland 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.