Electrocardiogram (EKG, tracing only)
Facility: Susan B Allen Memorial Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $554
- Cash Discount Price: $102
- vs. Medicare Baseline: 9.19x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 919% of the Medicare baseline (a markup of 819%). 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.
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 | $350 | 581% |
| Providrs Care | $757 | 1256% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (EKG, tracing only) procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $102.00, which is significantly lower than the facility's gross charge of $157.00. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are $350.00 and $757.00 respectively, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $102.00. It is important to note that the facility's negotiated rates are substantially higher than the Medicare benchmark of $60.27, which serves as the objective baseline for fair pricing. Additionally, the cash price is lower than the state average for this service, making it a competitive option for those paying out-of-pocket.
To maximize savings, patients should inquire about "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid in full upfront, effectively bypassing the administrative costs associated with insurance claims. If you have insurance, be aware that balance billing could occur if you are treated as out-of-network, though the No Surprises Act protects you from such unexpected charges for emergency care and non-emergency services at in-network facilities. Before scheduling, request a waiver of insurance submission to ensure the hospital applies the cash rate rather than submitting a claim that could void any discount. Finally, always ask for an itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit.