Electrocardiogram (EKG, tracing only)
Facility: Lmh
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $61
- Cash Discount Price: $150
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| UnitedHealthcare | $21 - $397 | 35% |
| Blue Cross Blue Shield | $21 - $387 | 35% |
| Cigna | $59 - $400 | 98% |
| Medicare (plans) | $59 | 98% |
| Humana | $59 | 98% |
| Haskell Indian Health Services | $59 | 98% |
| Allwell | $61 | 101% |
| Ambetter / Centene | $92 | 153% |
| Aetna | $381 - $497 | 632% |
| Non Contracted | $479 | 795% |
| First Health | $556 | 923% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Lmh in Lawrence, KS, the facility's cash price of $150.00 is significantly lower than the negotiated rates charged by major insurers like UnitedHealthcare, Blue Cross Blue Shield, and Aetna, which range from $21 to nearly $500 depending on the plan. While the facility's cash rate is higher than the state average for this procedure, it remains substantially below the gross chargemaster price of $598.00. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance allowed amounts, which can sometimes exceed the cash rate due to administrative costs and contract structures. It is important to note that while the facility is government-owned and offers a self-pay option, patients should explicitly ask about "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible upfront rate.
The Medicare benchmark for this service is $60.27, which serves as a reliable baseline for evaluating the facility's pricing markup. The facility's cash rate of $150.00 represents a markup of approximately 1.5 times the Medicare amount, which aligns with the generally accepted range of 120% to 150% for fair pricing. In contrast, the median negotiated rate across payers is $61.00, which is slightly higher than the Medicare benchmark but still lower than the facility's cash price for those who choose to pay out-of-pocket. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, and they should be aware that