CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $58
  • Cash Discount Price: $237
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Mercy Hospital Pittsburg, Inc is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 0.96x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$237

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $237 (393%)
Insurance Median: $58 (96%)
Cash: $237 (393% of Medicare)
Ins. Median: $58 (96% 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.

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
Humana $5 - $57 8%
Aetna $5 - $309 8%
Medicaid / KanCare $5 - $58 8%
Blue Cross Blue Shield $21 - $198 35%
UnitedHealthcare $51 - $245 85%
Tricare $57 95%
Pace Of The Ozarks Contracted [320518] $57 95%
American Health Advantage Of Ks Mcr Contracted [320508] $57 95%
Halo Hcr Inc Hospice Contracted [320432] $57 95%
Halo Hcr Inc Hospice [20432] $57 95%
Kindful Hospice [20434] $57 95%
Elara Caring Aspire Hospice [20433] $57 95%
Cross Timbers Hospice [20098] $57 95%
Medicare (plans) $57 - $59 95%
Mercy Hospice Okc [20252] $57 95%
Dept Of Veteran Affairs Contracted [320106] $57 95%
Kindful Hospice Contracted [320434] $57 95%
Home State Health Plan Contracted [320187] $58 96%
Ambetter / Centene $58 96%
Providrs Care Network Contracted [320484] $110 183%
Health Choice Contracted [320166] $119 197%
Medica Contracted [320239] $132 219%
United Medical Resources Contracted [320454] $245 407%
Cigna $251 - $280 416%
Aither Health Contracted [320449] $291 483%
Edison Health Solutions Contracted [320502] $291 483%
Auxiant Contracted [320462] $291 483%
Reflect Health Contracted [320492] $291 483%
American Healthcare Alliance Contracted [320020] $291 483%
Imagine 360 Contracted [320494] $291 483%
Healthlink Contracted [320179] $291 483%
Mercy Benefit Admin Contracted [320251] $291 483%
Yuzu Health Contracted [320521] $291 483%
Workers Comp [20426] $291 483%
Ebms Contracted [320493] $291 483%
First Health Contracted [320128] $309 513%

Consumer Guidance & Cost Commentary

For the Electrocardiogram (EKG, tracing only) service at Mercy Hospital Pittsburg, Inc, the facility's cash price of $237.00 is significantly higher than the state average of $59.00, though it aligns closely with the Medicare benchmark of $60.27. While commercial insurance plans like Humana and Aetna negotiate rates ranging from $5 to $309, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $237.00 rate is lower than many in-network negotiated fees, provided they can secure a "waiver of insurance submission" to avoid automatic claims processing that would void any cash discount.

To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their appointment, as hospitals often offer 20% to 50% reductions for upfront payments that bypass costly claims processing. It is important to verify your specific plan's allowed amount before visiting, as assuming that being in-network guarantees the lowest price can lead to unexpected bills if the negotiated rate is higher than the cash option. Additionally, if you receive an itemized bill, review it carefully for errors or unbundled codes, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit dispute rather than accepting the summary invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals