CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Children's Hospital of Philadelphia

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $160
Cash Discount Price: $528
vs. Medicare Baseline: 2.65x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Children's Hospital of Philadelphia is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $528. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.65x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$528

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $528 (876%)

Insurance Median: $160 (265%)

Cash: $528 (876% of Medicare)

Ins. Median: $160 (265% 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 265% of the Medicare baseline (a markup of 165%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geisinger Medical Assistance	$14	23%
Medicaid / KanCare	$41 - $133	68%
UnitedHealthcare	$42 - $442	70%
Health Partners	$47 - $152	78%
Aetna	$66 - $402	110%
Highmark Wholecare	$69 - $219	114%
Upmc Medical Assistance	$69 - $219	114%
Keystone First Chip	$78 - $249	129%
Keystone Health Plan East	$79 - $254	131%
Blue Cross Blue Shield	$89 - $322	148%
Geisinger Health Plan Commercial	$111 - $354	184%
Jefferson Health Plans	$119 - $380	197%
Cigna	$126 - $402	209%
Highmark	$126 - $402	209%
Qualcare	$138 - $442	229%
Horizon Nj Health	$156	259%
First Health Network	$163 - $522	270%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$201 - $643	333%
Private Health Care Systems	$201 - $643	333%
Choice Care Network	$226 - $723	375%

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 $528.
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 Children's Hospital of Philadelphia 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.