CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Harlem Hospital Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $82
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Harlem Hospital Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.36x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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%)

Insurance Median: $82 (136%)

Ins. Median: $82 (136% 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
Healthfirst	$6 - $180	10%
Emblem	$7 - $108	12%
Aetna	$8 - $13	13%
Wellcare	$8	13%
Fidelis	$11 - $180	18%
Blue Cross Blue Shield	$28 - $180	46%
Elderplan	$70	116%
Vaccn	$70	116%
Vnsny	$70 - $82	116%
Centers Plan For Healthy Living	$73	121%
Metroplus	$75 - $180	124%
Amidacare	$80	133%
Carelon	$80 - $266	133%
Senior Whole Health	$80	133%
United	$80 - $136	133%
United Behavioral Health	$80 - $88	133%
Affinity	$82 - $180	136%
Carelon (Amida Care)	$82	136%
Oscar	$105	174%
Oxford	$112 - $128	186%
Centerlight	$204	338%
Cigna	$307	509%
Magnacare	$307	509%
Multiplan	$327	543%
Local 1199	$347	576%
Villagecare Max	$347	576%

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 $X.
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 Harlem Hospital Center 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.