CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Charleston Area Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $281
Cash Discount Price: $433
vs. Medicare Baseline: 4.66x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Charleston Area Medical Center is $281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 4.66x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$433

Average discount available for prompt cash payment at this facility.

Insurance Median

$281

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: $433 (718%)

Insurance Median: $281 (466%)

Cash: $433 (718% of Medicare)

Ins. Median: $281 (466% 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 466% of the Medicare baseline (a markup of 366%). 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
Aetna	$4 - $542	7%
The Health Plan Of West Virginia Inc.	$4 - $536	7%
Unicare Health Plan Of West Virginia Inc.	$4 - $6	7%
Blue Cross Blue Shield	$6 - $504	10%
Choicecare Network	$6 - $542	10%
Optimum Choice Inc.	$6 - $60	10%
Triwest Va	$6 - $58	10%
UnitedHealthcare	$6 - $542	10%
West Virginia Senior Advantage Inc.	$7 - $63	12%
City Of Charleston	$8 - $415	13%
Caresource	$9 - $151	15%
Integrated Medical Solutions	$9 - $118	15%
Naphcare	$9 - $121	15%
Tricare	$28 - $332	46%
Healthsmart	$45 - $542	75%
Multiplan	$45 - $542	75%
Three Rivers Providers Network	$45 - $536	75%
Cigna	$46 - $514	76%

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 $433.
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 Charleston Area 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.