CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: St Anthony Community Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $232
  • Cash Discount Price: $774
  • vs. Medicare Baseline: 3.85x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at St Anthony Community Hospital is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $774. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.85x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$774

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $774 (1284%)
Insurance Median: $232 (385%)
Cash: $774 (1284% of Medicare)
Ins. Median: $232 (385% 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 385% of the Medicare baseline (a markup of 285%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Emblem $15 - $27 25%
Emblem Select Care (Exchange) $19 32%
Emblem Ghi/Hip PPO $23 38%
Mvp Exchange $27 45%
Emblem Ghi/Hip Hmo/Epo/Pos $27 45%
Mvp Hmo/Ppo $52 86%
Hamaspik (McR) $73 121%
Mvp Gold (McR) $73 121%
Medicare (plans) $73 - $78 121%
Tricare $74 123%
Blue Cross Blue Shield $76 - $526 126%
Affinity By Molina McR $77 128%
Self-Pay $84 139%
Self-Pay - Cc 30% $232 385%
Geisinger Health Commercial/Exchange $242 402%
Aetna $348 - $387 577%
Self-Pay - Cc 50% $387 642%
Cdphp $387 642%
Oxford $510 - $793 846%
Cigna $542 899%
Oxford Commercial $546 906%
PHCS $580 962%
Multiplan $580 962%
Magnacare Preferred $697 1156%
UnitedHealthcare $747 - $943 1239%
First Health $774 1284%
Oxford Exchange $802 1331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals