CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Adena Pike Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $232
  • Cash Discount Price: $154
  • vs. Medicare Baseline: 3.85x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Adena Pike Medical Center is $232. 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 3.85x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$154

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $232 (385%)
Cash: $154 (256% of Medicare)
Ins. Median: $232 (385% 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 385% of the Medicare baseline (a markup of 285%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $74 - $250 123%
Blue Cross Blue Shield $74 - $266 123%
Buckeye Community Health Plan $74 123%
Humana $74 - $292 123%
Medical Mutual Of Ohio $74 - $196 123%
Medigold $74 123%
Molina $74 123%
Care Source $75 124%
Gateway Health $102 169%
Molina Marketplace $121 201%
Care Source Just4Me $133 221%
Sidecar Health $203 337%
Ohio Ppo Connect $215 357%
The Health Plan $215 357%
Cigna $223 370%
Medical Mutual Of Ohio Supermed $232 385%
First Health $241 400%
Ohio Health Choice $245 407%
UnitedHealthcare $265 440%
Integrated Health Plan $289 480%
Healthsmart $292 484%
Multiplan/Private Healthcare Systems $292 484%
Three Rivers Network $292 484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals