CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Astria Toppenish Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $182
Cash Discount Price: $285
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Astria Toppenish Hospital is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.02x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $285 (473%)

Insurance Median: $182 (302%)

Cash: $285 (473% of Medicare)

Ins. Median: $182 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Medicaid / KanCare	$5 - $109	8%
Regence	$11 - $195	18%
Premera	$12 - $217	20%
Premera_Affordable_Care	$12 - $217	20%
Chpw_Cascade_Care	$20 - $362	33%
First_Choice	$22 - $397	37%
Ambetter / Centene	$24	40%
Medicare (plans)	$24 - $475	40%
Molina	$24	40%
UnitedHealthcare	$24 - $475	40%
Va	$24	40%
Tpsc	$25 - $448	41%
Aetna	$28 - $506	46%
Molina_Exchange	$31	51%
Bcchp	$32 - $575	53%
Great_Rivers	$32 - $575	53%
Healthcomp	$32 - $575	53%
Humana	$32 - $575	53%
Washington_State_Hca	$32 - $575	53%
Li	$59	98%
Cigna	$62	103%
Tricare	$62	103%
Zenith	$63	105%
Kaiser	$226	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 $285.
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 Astria Toppenish 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.