Electrocardiogram (EKG, tracing only)
Facility: Pratt Regional Medical Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $58
- Cash Discount Price: $100
- vs. Medicare Baseline: 0.96x 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.
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 |
|---|---|---|
| Christian Health Aid | $26 - $188 | 43% |
| UnitedHealthcare | $29 - $255 | 48% |
| Health Partners Of Kansas | $30 - $213 | 50% |
| Aetna | $32 - $225 | 53% |
| Choicecare | $35 - $250 | 58% |
| Celtic Insurance Company | $57 | 95% |
| Healthy Blue | $58 | 96% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (EKG, tracing only) procedure at Pratt Regional Medical Center in Pratt, KS, the cash price is $100.00, which is significantly lower than the facility's gross charge of $143.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $29 to $255, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts. The facility's negotiated average of $58.00 sits below the cash rate, but individual payer contracts vary widely; for instance, Celtic Insurance Company and Healthy Blue have fixed negotiated rates of $57 and $58, respectively. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest cost can be misleading when cash rates are already competitive.
This service is benchmarked against Medicare, which sets a fixed rate of $60.27 for this procedure. The facility's cash price of $100.00 is approximately 1.66 times the Medicare amount, while the median negotiated rate of $58.00 is roughly 0.96 times the Medicare rate, indicating that some commercial contracts align closely with or even fall below the federal baseline. Given that over 80% of hospital bills contain errors, consumers should request a full itemized CPT-coded statement rather than accepting summary bills to ensure no unbundled charges or services not rendered are included. If a balance bill arises from an out-of-network ancillary service, patients should not pay immediately but instead dispute the claim with their insurer