Electrocardiogram (EKG, tracing only)
Facility: Providence Medical Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $56
- Cash Discount Price: $55
- vs. Medicare Baseline: 0.93x 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 |
|---|---|---|
| Oha Networks | $14 | 23% |
| Aetna | $15 - $56 | 25% |
| Worker Compensation | $15 | 25% |
| First Health | $15 | 25% |
| Medicaid / KanCare | $21 | 35% |
| Celtic | $21 - $89 | 35% |
| UnitedHealthcare | $21 - $684 | 35% |
| Healthy Blue | $21 - $58 | 35% |
| Cigna | $56 | 93% |
| Tricare | $56 | 93% |
| Medicare (plans) | $56 | 93% |
| Midland Care Connection | $56 | 93% |
| Kansas Superior Select | $58 | 96% |
| Corizon | $72 | 119% |
| Employer Direct Healthcare | $78 | 129% |
| Well Path Prison | $78 | 129% |
| Centurion | $83 | 138% |
| Naphcare | $86 | 143% |
| Blue Cross Blue Shield | $89 - $103 | 148% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Providence Medical Center in Kansas City, KS, the cash price of $55.00 is significantly lower than the facility's negotiated rates with most insurance payers, which range from $56.00 to $89.00. While the median negotiated amount across payers is $56.00, the cash price represents a substantial discount that could save patients with high-deductible plans or those without insurance. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums, making them higher than the cash price even though they are designed to cap out-of-pocket costs for insured members. Patients should verify their specific plan's deductible status before assuming insurance will result in a lower total cost, as paying the full negotiated rate upfront may exceed the cash price if the deductible has not yet been met.
When evaluating the true cost of this service, it is more accurate to compare rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare amount for this code is $60.27, which serves as a scientifically validated baseline for the actual cost of delivery. The facility's cash price of $55.00 is slightly below this benchmark, while the median negotiated rate of $56.00 is only marginally higher. Although the data does not provide specific state or county average comparisons for this code, the facility's ownership as a voluntary non-profit church entity and its location in Kansas City (ZIP 66112) are relevant context for understanding regional pricing dynamics. Patients are encouraged to request a prompt-pay discount, which can further reduce the final bill by paying in full upfront, bypassing