CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Fort Memorial Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $84
Cash Discount Price: $73
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Fort Memorial Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.39x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$84

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: $73 (121%)

Insurance Median: $84 (139%)

Cash: $73 (121% of Medicare)

Ins. Median: $84 (139% 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.

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
Humana	$6 - $57	10%
Molina	$6 - $57	10%
Blue Cross Blue Shield	$11 - $158	18%
Dean Health Plan	$11 - $180	18%
Medicaid / KanCare	$11	18%
Quartz	$11 - $61	18%
UnitedHealthcare	$11 - $57	18%
Managed Health Services	$12	20%
Fort Care	$25	41%
Aetna	$32 - $180	53%
Group Health Cooperative	$51 - $259	85%
Alliance	$57 - $173	95%
Medicare (plans)	$57	95%
Mercycare	$59 - $179	98%
Trilogy	$70 - $211	116%
Veteran Evaluation Services	$71	118%
Cigna	$75 - $228	124%
Centivo	$125	207%

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 $73.
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 Fort Memorial 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.