CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $87
Cash Discount Price: $81
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Gundersen St Josephs Hospital and Clinics is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.44x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $81 (134%)

Insurance Median: $87 (144%)

Cash: $81 (134% of Medicare)

Ins. Median: $87 (144% 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
Amerigroup	$11	18%
Security Health Plan	$27	45%
Blue Cross Blue Shield	$69 - $102	114%
Iowa Total Care	$69	114%
Managed Health Service	$69	114%
Ucare	$73 - $112	121%
UnitedHealthcare	$74 - $98	123%
Quartz	$76	126%
Alliance	$112 - $133	186%
Cigna	$115	191%
Aspirus Arise Health	$116	192%
Humana	$119	197%
Multiplan/Healtheos	$122 - $133	202%
Coventry Health Care	$133	221%

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 $81.
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 Gundersen St Josephs Hospital and Clinics 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.