CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Physicians Care Surgical Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $238
  • Cash Discount Price: $190
  • vs. Medicare Baseline: 3.95x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Physicians Care Surgical Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.95x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$190

Average discount available for prompt cash payment at this facility.

Insurance Median
$238

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: $190 (315%)
Insurance Median: $238 (395%)
Cash: $190 (315% of Medicare)
Ins. Median: $238 (395% 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 395% of the Medicare baseline (a markup of 295%). 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
Connecticare $61 101%
Blue Cross Blue Shield $108 - $257 179%
Highmark $108 179%
Aetna $142 - $266 236%
Ag Administrators $142 236%
Ag Administrators Inc $142 236%
Allied Benefit Systems $142 236%
Allied Benefits Systems $142 236%
Continental Benefits $142 236%
Coventry $142 236%
Geha $142 236%
Healthez $142 236%
Lucent Health $142 236%
Marpai Health $142 236%
Meritain Health $142 236%
Premier Care Network $142 236%
Trustmark $142 236%
Aarp $238 395%
Cigna $238 395%
Devon Health Services $238 395%
Gpm Health And Life Insurance Mc Supplement $238 395%
Humana $238 395%
Ibc Security 65 $238 395%
Keystone 65 Hmo $238 395%
Medicare (plans) $238 395%
Pcsh Aarp $238 395%
Personal Choice 65 $238 395%
Shenandoah Life $238 395%
Tricare $238 395%
Unified Health Services $238 395%
UnitedHealthcare $238 - $504 395%
Vibra Health Plan $238 395%
Amerihealth Administrators $257 426%
Amerihealth New Jersey Hmo $257 426%
Carefirst Administrators $257 426%
Empire Plan $257 426%
Horizon Of New Jersey $257 426%
Ibc $257 426%
Ibc - Local $257 426%
Ibc 2021 $257 426%
Ibc Local $257 426%
Independence Administrators $257 426%
Independence Bc $257 426%
Independence Federal $257 426%
Keystone Direct Pos $257 426%
Keystone Healthplan East $257 426%
Keystone Hmo $257 426%
Pcsh Ibc $257 426%
Personal Choice $257 426%
Regence Blue Shield $257 426%
Allsavers $504 836%
Golden Rule Op $504 836%
Oxford Health Plan $504 836%
Oxford Life Insurance Company $504 836%
Surest $504 836%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals