CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Pennsylvania Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $254
  • Cash Discount Price: $794
  • vs. Medicare Baseline: 4.21x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Pennsylvania Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $794. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.21x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$794

Average discount available for prompt cash payment at this facility.

Insurance Median
$254

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: $794 (1317%)
Insurance Median: $254 (421%)
Cash: $794 (1317% of Medicare)
Ins. Median: $254 (421% 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 421% of the Medicare baseline (a markup of 321%). 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
Cigna $7 - $430 12%
Gateway Health Plan $10 - $77 17%
Medicaid / KanCare $10 - $1,271 17%
Pa Medical Assistance $10 17%
Keystone Mercy Health Plan $13 22%
Health Partners $16 - $1,271 27%
Upmc $18 - $1,271 30%
UnitedHealthcare $21 - $1,271 35%
Aetna $35 - $1,271 58%
Horizon Nj Health $54 - $223 90%
Blue Cross Blue Shield $62 - $1,271 103%
Medicare (plans) $62 - $63 103%
Philadelphia Va Medical Center $62 103%
Tricare $62 103%
Ibc $63 105%
Geisinger Health Plan $64 - $196 106%
Humana $64 - $1,017 106%
Pa Health And Wellness $65 - $102 108%
Penn Life (Living Independently For Elders) $65 108%
Clover Health Plan $67 111%
Keystone First $68 113%
Us Family Health Plan $71 118%
Pgm - Regie De L'Assurance Maladie Quebec $73 - $292 121%
Preferred Health Care Eliance $82 - $330 136%
Elap $88 146%
Claims Watcher $99 - $111 164%
Ibc Commercial Hpn $102 169%
Keystone Hmo Proactive $105 174%
Oscar Health Plan $105 174%
Centivo $111 184%
Pgm - Kuwait Defense $111 - $572 184%
Elap Services $115 191%
Devon $120 - $572 199%
Qualcare $120 - $483 199%
Coventry $127 - $648 211%
Pgm - Chop $127 - $508 211%
Wissahickon Hospice $127 - $508 211%
Highmark $130 216%
Healthamerica/Coventry $143 - $623 237%
Olympus $154 - $618 256%
First Health Global $158 - $636 262%
Urn-Cancer Resource Services $158 - $636 262%
Penn Global Medicine $164 272%
Health Net $190 - $763 315%
Pgm - Royal Embassy Of Saudi Arabia $190 - $763 315%
Pgm - Embassy Of Qatar $206 - $826 342%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $206 - $826 342%
Pgm - Embassy Of The United Emirates/Ipc $222 - $890 368%
Devon Health Services Inc $254 - $1,017 421%
Health America/Ccn $254 - $1,017 421%
Intergroup $254 - $1,017 421%
Pgm - Kuwait Health Division $254 - $1,017 421%
Pgm - Kuwait Oil $254 - $1,017 421%
Preferred Care $254 - $1,017 421%
Commercial Other $317 - $1,271 526%
Community Behavioral Health $317 - $1,271 526%
International Pfs $317 - $1,271 526%
Quest Behavioral Health $317 - $1,271 526%
United Behavioral Health $317 - $1,271 526%
Workers Compensation $317 - $1,271 526%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals