CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Penn State Health St. Joseph

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $68
Cash Discount Price: $100
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Penn State Health St. Joseph is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.13x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $100 (166%)

Insurance Median: $68 (113%)

Cash: $100 (166% of Medicare)

Ins. Median: $68 (113% 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.

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
[Amerihealth Caritas]	$51 - $60	85%
[Highmark Wholecare]	$51 - $60	85%
[Geisinger]	$54 - $278	90%
[Health Partners Plans]	$56 - $61	93%
[Pa Health & Wellness]	$56 - $62	93%
[Highmark]	$59 - $326	98%
UnitedHealthcare	$60 - $261	100%
[Cbc]	$60 - $204	100%
[Ibc]	$60 - $192	100%
Aetna	$61 - $197	101%
Humana	$61	101%
[Healthspring]	$61	101%
[Upmc]	$61 - $285	101%
[Point Comfort Underwriters]	$75	124%
Cigna	$237	393%
[Highmark Choice Blue]	$261	433%
[Highmark Aca]	$274	455%
[Preferred Healthcare Systems]	$290	481%
[First Health]	$309	513%
[Multiplan]	$309	513%

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 $100.
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 Penn State Health St. Joseph 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.