Electrocardiogram (ECG/EKG)
Facility: Nmc Health
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $44
- Cash Discount Price: $49
- vs. Medicare Baseline: 2.86x 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 $15.36 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 286% of the Medicare baseline (a markup of 186%). 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 |
|---|---|---|
| Bluestem Pace | $14 | 91% |
| Medicaid / KanCare | $22 | 143% |
| Leading Age | $22 | 143% |
| Wppa | $39 | 254% |
| Aetna | $42 - $58 | 273% |
| Occunet | $42 | 273% |
| Medincrease Health Plan | $46 | 299% |
| Samaritan Ministries International | $46 | 299% |
| Prime Health Services | $53 | 345% |
| UnitedHealthcare | $63 | 410% |
| Cigna | $67 | 436% |
Consumer Guidance & Cost Commentary
For an Electrocardiogram (ECG/EKG) at Nmc Health in Newton, Kansas, the cash median price is $49.00, which is lower than the facility's gross charge of $70.00. While the facility's negotiated rates with insurance payers range from $14 to $67, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price, so patients should verify their specific plan's allowed amount before scheduling. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if paid in full upfront.
This service is benchmarked against federal standards, where the Medicare amount for this procedure is $15.36. The facility's cash rate of $49.00 represents a 2.9x markup compared to the Medicare baseline, which is consistent with the typical range of 200% to 300% seen in commercial pricing structures. Since the data does not provide specific state or county average comparisons for this code, the focus remains on the relationship between the cash price, the Medicare benchmark, and the facility's negotiated rates. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act, and they should always request an itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.