CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Kenmore Mercy Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $8
Cash Discount Price: $123
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Kenmore Mercy Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 0.13x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $123 (204%)

Insurance Median: $8 (13%)

Cash: $123 (204% of Medicare)

Ins. Median: $8 (13% 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
UnitedHealthcare	$4 - $9	7%
Univera Healthcare Essential [100170]	$5 - $9	8%
Beacon Essential [350122]	$5 - $8	8%
VA Veterans Affairs [700001]	$5	8%
Univera Healthcare [100169]	$5 - $9	8%
Medicaid / KanCare	$5 - $48	8%
Fidelis Dual Advantage [450120]	$6	10%
Covid19 Hrsa [45013]	$6	10%
Cigna	$6 - $9	10%
Medicare (plans)	$6 - $69	10%
Aetna	$6	10%
Tricare	$6	10%
Champ VA [700002]	$6	10%
Wellcare Fidelis Dual [450451]	$6	10%
Humana	$6	10%
Catholic Health Life Pace [400005]	$6	10%
Hospice [550001]	$6	10%
Fallon Health [450115]	$6	10%
Seneca Nation [450119]	$6	10%
Wellcare [450129]	$7	12%
Beacon Health Options [100023]	$7	12%
Iha First Choice [800001]	$7 - $103	12%
Independent Health [100165]	$7 - $115	12%
Ghi [100153]	$7	12%
Fidelis Exchange [100164]	$7	12%
Fidelis Essential [100163]	$7 - $17	12%
Amerigroup [350102]	$8	13%
Excellus Rochester McD [350117]	$8	13%
Blue Cross Blue Shield	$8 - $17	13%
Tuscarora Nation [550120]	$8	13%
Crime Victims [100176]	$8	13%
Mvp Healthcare [100168]	$10	17%
UPMC Health Plan [100181]	$11	18%
Federal Workers Compensation [500100]	$14 - $44	23%
Molina Essential [100167]	$17	28%
No Fault [114001]	$44 - $59	73%
Independent Health Essential [100166]	$48 - $57	80%

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 $123.
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 Kenmore Mercy 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.