CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Prisma Health Tuomey Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $149
  • Cash Discount Price: $293
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Prisma Health Tuomey Hospital is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $293. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.47x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$293

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $293 (486%)
Insurance Median: $149 (247%)
Cash: $293 (486% of Medicare)
Ins. Median: $149 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Blue Cross Blue Shield $35 - $149 58%
Bluechoice [810] $35 - $149 58%
Cigna $55 - $345 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $55 91%
Humana $55 - $338 91%
Medicare (plans) $55 - $58 91%
Triwest Healthcare Alliance Vcp [902] $55 91%
Va Community Care Network-Vaccn [903] $55 91%
Tricare $56 93%
UnitedHealthcare $57 - $185 95%
Aetna $58 - $356 96%
Healthy Conn Prime-First Choice Vip Care [5300] $58 96%
Healthy Conn Prime-Molina Healthcare [5330] $58 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $58 96%
Medicaid / KanCare $69 - $156 114%
Workers Comp [600] $77 128%
Scdc-Sc Dept Of Corrections [7232] $84 139%
Bob Jones Univ-Pai [821] $96 159%
Ambetter / Centene $101 168%
Prisma Health Seniorcare Pace - Midlands [5400] $104 173%
Prisma Health Seniorcare Pace-Upstate [5200] $104 173%
Planned Administrators [820] $149 247%
Promise Health Plan Contracted [2401] $158 - $270 262%
Orangeburg Senior Helping Center Pace [5401] $180 299%
Golden Rule Insurance Company [2991] $185 307%
Oxford Health Plans [2992] $185 307%
Zzumr-Salt Lake City Ut [3169] $185 307%
Meritain Health Contracted [2200] $288 - $356 478%
Preferred Administrators Contracted [2839] $315 523%
Medcost [2940] $333 - $374 553%
Atlantic Packaging Contracted [4833] $338 561%
Aps Healthcare System [2981] $360 597%
Multiplan/Phcs Contracted [2950] $400 664%
Vsp Vision Care [2986] $405 672%
First Health Contracted [2952] $418 694%
Furman Int/Allen University Student [2951] $418 694%
Quiktrip-First Health [3067] $418 694%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals