CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Uva Health Culpeper Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $158
Cash Discount Price: $116
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Uva Health Culpeper Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.62x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $116 (192%)

Insurance Median: $158 (262%)

Cash: $116 (192% of Medicare)

Ins. Median: $158 (262% 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 262% of the Medicare baseline (a markup of 162%). 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
Champva [50002]	$6	10%
Tricare	$6	10%
Sentara [40021]	$39 - $179	65%
Sentara Behavioral Health [40052]	$40 - $179	66%
Carefirst [30007]	$42 - $52	70%
Blue Ridge Pace [10510]	$53	88%
Medicaid / KanCare	$53	88%
Aetna	$59 - $362	98%
Blue Cross Blue Shield	$59 - $177	98%
Cigna	$59 - $199	98%
HMO Part B [10099]	$59	98%
Humana	$59 - $62	98%
Medicare (plans)	$59 - $61	98%
UnitedHealthcare	$59 - $322	98%
VA Ccn [99926]	$59 - $61	98%
VA Ccn [99927]	$59 - $61	98%
Veterans Administration [99910]	$61	101%
Multiplan Generic [40035]	$176 - $349	292%
Vhn Generic [40040]	$176 - $349	292%
Beacon Health Options [40012]	$206	342%
Kaiser Permenente [40014]	$208	345%
Commercial Contracted Hb Only [40056]	$216	358%
Commercial Generic [40000]	$216 - $288	358%
Geha [40009]	$239 - $259	397%
Commercial Contracted Tpa [40055]	$247 - $288	410%
Umwa [40037]	$288	478%
Healthsmart [40013]	$308	511%
First Health Generic [40033]	$337	559%
Gateway Health Alliance [40034]	$349	579%
Onenet Workers Comp Generic [60010]	$360	597%

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 $116.
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 Uva Health Culpeper Medical Center 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.