CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Texas Childrens Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $390
Cash Discount Price: $436
vs. Medicare Baseline: 6.47x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Texas Childrens Hospital is $390. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 6.47x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$436

Average discount available for prompt cash payment at this facility.

Insurance Median

$390

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: $436 (723%)

Insurance Median: $390 (647%)

Cash: $436 (723% of Medicare)

Ins. Median: $390 (647% 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 647% of the Medicare baseline (a markup of 547%). 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
First Care Health Plan	$123 - $557	204%
UnitedHealthcare	$123 - $557	204%
Driscoll Children'S Health Plan Mcd	$137 - $261	227%
Molina Mcd	$137 - $261	227%
Blue Cross Blue Shield	$160 - $549	265%
Community Health Choice	$161 - $557	267%
Community First Health Plan Mcd	$183 - $348	304%
Cook Children'S Health Plan	$183 - $348	304%
Cigna	$260 - $557	431%
Aetna	$292 - $557	484%
Kelseycare	$297 - $566	493%
Healthsmart	$320 - $610	531%
Evolutions Healthcare	$343 - $653	569%
First Health	$402 - $827	667%
Multiplan	$411 - $784	682%
Galaxy Health Network	$434 - $827	720%

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 $436.
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 Texas Childrens Hospital 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.