CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Unitypoint Health - Meriter

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $70
Cash Discount Price: $244
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Unitypoint Health - Meriter is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.16x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$244

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $244 (405%)

Insurance Median: $70 (116%)

Cash: $244 (405% of Medicare)

Ins. Median: $70 (116% 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
Aspirus	$6 - $183	10%
Blue Cross Blue Shield	$6 - $290	10%
Humana	$6 - $57	10%
Illinicare	$6 - $57	10%
Meridiancare	$6 - $57	10%
Prevea 360	$6 - $260	10%
UnitedHealthcare	$6 - $126	10%
Health Partners Open Network	$15 - $112	25%
Wellmark Uph Self-Funded	$18 - $176	30%
Medical Associates Health Plan	$24 - $110	40%
Cigna	$55 - $92	91%
Security Health Plan	$59 - $95	98%
Mercy Care	$69 - $101	114%
Quartz	$95	158%

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 $244.
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 Unitypoint Health - Meriter 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.