CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Clarion Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $63
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Clarion Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.05x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $115 (191%)
Insurance Median: $63 (105%)
Cash: $115 (191% of Medicare)
Ins. Median: $63 (105% 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.

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
Medicaid / KanCare $10 17%
Geisinger $11 - $60 18%
Upmc $11 - $154 18%
Amerihealth $12 - $57 20%
Jefferson Health Plan $12 20%
Highmark $36 - $104 60%
Highmark - Ind.& Managed Care $36 - $128 60%
Martin'S Point - Usfhp $37 - $107 61%
Gateway $39 - $114 65%
Devoted Health Plan $42 - $123 70%
Aetna $52 - $273 86%
Cigna $52 - $154 86%
Highmark Community Blue $57 95%
Medicare (plans) $57 95%
Tricare $57 95%
UnitedHealthcare $57 95%
Workers Comp $57 95%
Pa Health & Wellness $61 101%
The Health Plan $61 - $134 101%
American Health Plan $63 105%
Peak Health $74 - $215 123%
Devon $79 - $230 131%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals