CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Little Falls Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $75
Cash Discount Price: $72
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Little Falls Hospital is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.24x the Medicare baseline. Located in 140 Burwell Street, Little Falls, NY.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

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: $72 (119%)

Insurance Median: $75 (124%)

Cash: $72 (119% of Medicare)

Ins. Median: $75 (124% 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
Blue Cross Blue Shield	$5 - $248	8%
Emblem	$5 - $75	8%
Fidelis	$5 - $80	8%
Mvp	$5 - $77	8%
Cdphp	$8 - $77	13%
UnitedHealthcare	$8 - $75	13%
Aetna	$75 - $80	124%
Humana	$75 - $81	124%
Cigna	$227	377%

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 $72.
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 Little Falls 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.