CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Adena Regional Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $209
Cash Discount Price: $154
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Adena Regional Medical Center is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.47x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $154 (256%)

Insurance Median: $209 (347%)

Cash: $154 (256% of Medicare)

Ins. Median: $209 (347% 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 347% of the Medicare baseline (a markup of 247%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$57 - $219	95%
Buckeye Community Health Plan	$57	95%
Humana	$57 - $292	95%
Medical Mutual Of Ohio	$57 - $203	95%
Medigold	$57	95%
Molina	$57	95%
UnitedHealthcare	$57 - $222	95%
Care Source	$58	96%
Gateway Health	$58	96%
Molina Marketplace	$93	154%
Care Source Just4Me	$102	169%
Cigna	$110 - $190	183%
Blue Cross Blue Shield	$140 - $196	232%
Sidecar Health	$156	259%
Ohio Ppo Connect	$215	357%
The Health Plan	$215	357%
First Health	$241	400%
Ohio Health Choice	$245	407%
Healthsmart	$262	435%
Integrated Health Plan	$292	484%
Multiplan/Private Healthcare Systems	$292	484%
Three Rivers Network	$292	484%

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 $154.
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 Adena Regional Medical 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.