CMS Price Transparency Data

Electrocardiogram (ECG/EKG)

Facility: Clarion Hospital

Billing Code: 93000 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93000
Insurance Median: $21
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (ECG/EKG) at Clarion Hospital is $21. 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 $15.36, this hospital’s rate is 1.37x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$15.36

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.36 (100%)

Insurance Median: $21 (137%)

Ins. Median: $21 (137% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $15.36 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
Upmc	$11 - $48	72%
Martin'S Point - Usfhp	$13	85%
Tricare	$13	85%
Medicaid / KanCare	$19	124%
Amerihealth	$21	137%
Jefferson Health Plan	$21	137%
Geisinger	$23	150%
Aetna	$35	228%
Workers Comp	$68	443%

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: 93000.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Clarion Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93000.
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.