CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: St Mary Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $167
  • Cash Discount Price: $359
  • vs. Medicare Baseline: 2.77x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at St Mary Medical Center is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.77x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$359

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $359 (596%)
Insurance Median: $167 (277%)
Cash: $359 (596% of Medicare)
Ins. Median: $167 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
Medicaid / KanCare $12 - $22,542 20%
Aetna $15 - $29,824 25%
UnitedHealthcare $17 - $9,963 28%
Pace-Trinity Health $24 40%
Keystone First $25 - $2,581 41%
Keystone First Chip $25 - $2,581 41%
Blue Cross Blue Shield $64 - $28,178 106%
Cigna $64 - $28,443 106%
Align Senior Care $65 - $28,742 108%
Medicare (plans) $65 - $50,720 108%
Health America Advantra $76 - $33,814 126%
Geha $98 - $9,963 163%
Ambetter / Centene $114 - $50,298 189%
Oscar $114 - $50,720 189%
Prime Healthcare $114 - $50,720 189%
Jefferson Health Plan Commercial $116 - $51,284 192%
Homestead Health Plans Woods Center $124 - $54,947 206%
Upmc Health Plan $125 - $5,714 207%
Webtpa $125 - $5,714 207%
Group Pension Administrators $143 - $63,401 237%
Reedman Toll $143 - $63,401 237%
Meritain $165 274%
Multiplan $166 275%
Prime Health Services $166 275%
Blue Shield - Pa (Highmark) $172 - $76,193 285%
Galaxy Health Network $176 292%
Three Rivers Provider Network $176 292%
Amerihealth $6,805 11291%
Blue Shield - Ca $6,805 11291%
Blue Shield - Id (Regence) $6,805 11291%
Blue Shield - Ny Highmark Western $6,805 11291%
Blue Shield - Wa (Regence) $6,805 11291%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals