CMS Price Transparency Data
Electrocardiogram (EKG, tracing only)
Facility: Mount Carmel St Ann's
Billing Code: 93005 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93005
- Insurance Median: $146
- Cash Discount Price: $27,373
- vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Mount Carmel St Ann's is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,373. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.42x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$27,373
Average discount available for prompt cash payment at this facility.
Insurance Median
$146
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: $27,373 (45417%)
Insurance Median: $146 (242%)
Cash: $27,373 (45417% of Medicare)
Ins. Median: $146 (242% 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 242% of the Medicare baseline (a markup of 142%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $50 - $26,463 | 83% |
| Aetna | $56 - $44,210 | 93% |
| Blue Cross Blue Shield | $56 - $94,012 | 93% |
| Hospice Mount Carmel | $57 - $25,203 | 95% |
| UnitedHealthcare | $57 - $55,023 | 95% |
| The Health Plan | $58 - $25,707 | 96% |
| Oscar | $94 - $41,584 | 156% |
| Enterprise Group Planning | $110 - $48,641 | 183% |
| Custom Design Benefits | $119 - $52,674 | 197% |
| Geha | $128 - $55,023 | 212% |
| Gravie Admin Services | $128 | 212% |
| Healthez | $128 | 212% |
| Meritain | $128 | 212% |
| Webtpa | $128 | 212% |
| Quality Care Partners | $129 - $56,958 | 214% |
| Access Health | $133 | 221% |
| Acclaim | $133 | 221% |
| Administrative Concepts | $133 | 221% |
| Allegeant | $133 | 221% |
| Allied Benefit Systems | $133 | 221% |
| American Family | $133 | 221% |
| American Healthcare Alliance | $133 | 221% |
| American National | $133 | 221% |
| American Republic | $133 | 221% |
| Amerihealth | $133 | 221% |
| Aultcare | $133 | 221% |
| Automated Benefit Services | $133 | 221% |
| Auxiant | $133 | 221% |
| Benefit Administrative Systems,Llc | $133 | 221% |
| Boon Chapman | $133 | 221% |
| Cam Administrative Services | $133 | 221% |
| Christian Brother Services | $133 | 221% |
| Christian Brothers Holy Cross | $133 | 221% |
| Claimchoice Adminstrators | $133 | 221% |
| Comprehensive Benefits | $133 | 221% |
| Continental Life Insurance | $133 | 221% |
| Coventry | $133 | 221% |
| Custom Benefit Administrators | $133 | 221% |
| Cypress Benefit Administrators | $133 | 221% |
| Employee Benefit Concepts | $133 | 221% |
| Employee Benefit Management | $133 | 221% |
| Forest County Potawatomi | $133 | 221% |
| Freedom Life Insurance Company | $133 | 221% |
| Group Administrators | $133 | 221% |
| Group Marketing Services | $133 | 221% |
| Group Pension Administrators | $133 | 221% |
| Guardian | $133 | 221% |
| Health America | $133 | 221% |
| Health Choices | $133 | 221% |
| Healthcare Management Admin | $133 | 221% |
| Insight | $133 | 221% |
| Intercare | $133 | 221% |
| Jfp Benefit Management | $133 | 221% |
| Jp Farley Corporation | $133 | 221% |
| Key Benefit Administrator | $133 | 221% |
| Liberty Union Life Assurance Co | $133 | 221% |
| Lucent Health | $133 | 221% |
| Luminare Health | $133 | 221% |
| Magnacare | $133 | 221% |
| Medcost | $133 | 221% |
| Mutual Health Services | $133 | 221% |
| Mutual Of Omaha | $133 | 221% |
| Ncas | $133 | 221% |
| Nippon Life Ins | $133 | 221% |
| Nova | $133 | 221% |
| Painters Union Insurance Fund | $133 | 221% |
| Physicians Mutual | $133 | 221% |
| Plumbers Local 98 Insurance Fund | $133 | 221% |
| Prairie States | $133 | 221% |
| Preferred One | $133 | 221% |
| Primary Physician Care | $133 | 221% |
| Professional Benefit Administrators | $133 | 221% |
| Secureone Preferred United Plans | $133 | 221% |
| Siho Insurance Services | $133 | 221% |
| Sisco Benefits | $133 | 221% |
| The Loomis Company | $133 | 221% |
| Trustmark Small Business Benefits | $133 | 221% |
| U Of M Health Plan | $133 | 221% |
| Unicare | $133 | 221% |
| Unified Group Services | $133 | 221% |
| Us Health And Life | $133 | 221% |
| Valenz | $133 | 221% |
| Varipro | $133 | 221% |
| Wps | $133 | 221% |
| Medical Mutual | $140 - $89,671 | 232% |
| Humana | $146 - $285 | 242% |
| First Health | $150 | 249% |
| Paramount Hmo | $150 | 249% |
| American Postal Workers Secondary | $160 - $46,956 | 265% |
| Cigna | $160 - $46,956 | 265% |
| Health Partners | $160 - $46,956 | 265% |
| Healthgram | $160 - $46,956 | 265% |
| Mvp | $160 - $46,956 | 265% |
| Priority Health | $160 - $46,956 | 265% |
| Rural Carrier Health Benefit Plan | $162 - $44,210 | 269% |
| Medben | $171 - $214 | 284% |
| Consociate | $174 | 289% |
| Health Ohio Network | $174 | 289% |
| Western & Southern Financial Group | $202 - $89,671 | 335% |
| Caresource | $208 | 345% |
| Blue Benefit Administrators Of Massachusetts | $212 - $94,012 | 352% |
| Blue Care Network | $212 - $94,012 | 352% |
| Blue Distinction Transplant | $212 - $94,012 | 352% |
| Blue Shield - Ca | $212 - $94,012 | 352% |
| Blue Shield - Id (Regence) | $212 - $94,012 | 352% |
| Blue Shield - Ny Highmark Northeastern | $212 - $94,012 | 352% |
| Blue Shield - Ny Highmark Western | $212 - $94,012 | 352% |
| Blue Shield - Pa (Highmark) | $212 - $94,012 | 352% |
| Blue Shield - Wa (Regence) | $212 - $94,012 | 352% |
| Healthlink Inc | $214 | 355% |
| Medical Benefits Mutual | $214 | 355% |
| Ohio Health Choice | $214 | 355% |
| Ohio Ppo Connect | $214 | 355% |
| Ameriben | $228 | 378% |
| Luminare Health (Detroit) | $228 | 378% |
| Medi Share | $228 | 378% |
| Multiplan | $228 | 378% |
| Ohiohealthy | $228 | 378% |
| Osu Not Independent Choice | $228 | 378% |
| Phcs | $228 | 378% |
| Philadelphia American Life Insurance | $228 | 378% |
| Twin Valley Psychiatric | $228 | 378% |
| Health Smart | $242 | 402% |
| Bccp | $285 | 473% |
| Medicaid / KanCare | $285 | 473% |
| Optima Health | $285 | 473% |
| Crime Victim Assistance | $632 | 1049% |
| Ohio Safe Program | $632 | 1049% |