Electrocardiogram (EKG, tracing only)
Facility: Kansas Heart Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $142
- Cash Discount Price: $92
- vs. Medicare Baseline: 2.36x 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 236% of the Medicare baseline (a markup of 136%). 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 |
|---|---|---|
| Tricare | $49 | 81% |
| Medicaid / KanCare | $54 - $146 | 90% |
| UnitedHealthcare | $54 - $155 | 90% |
| Celtic Mcr Adv | $54 | 90% |
| Humana | $54 | 90% |
| Wppa - All Plans | $58 | 96% |
| Blue Cross Blue Shield | $123 - $146 | 204% |
| Multiplan - All Plans | $131 | 217% |
| Aetna | $142 - $146 | 236% |
| Soonerselect Mcaid - All Plans | $146 | 242% |
| Celtic Mcaid - All Other Plans | $146 | 242% |
Consumer Guidance & Cost Commentary
For CPT code 93005, an Electrocardiogram (EKG, tracing only), Kansas Heart Hospital in Wichita, KS, lists a gross charge of $146.00. While the facility offers a cash median price of $92.00, which is lower than the state average, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective than relying on insurance. Many commercial payers, including UnitedHealthcare and Blue Cross Blue Shield, have negotiated rates that exceed the cash price, meaning the insurance allowed amount could be higher than $92.00. To minimize out-of-pocket costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these programs often provide significant fee reductions for upfront payment.
The facility's negotiated rates vary significantly by payer, ranging from a low of $49.00 with Tricare to a high of $155.00 with UnitedHealthcare, with a median negotiated rate of $142.00. When comparing these commercial rates to the Medicare benchmark of $60.27, the facility's pricing reflects standard commercial markup dynamics where negotiated rates often average 200% to 300% of the Medicare rate. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, though the No Surprises Act protects you from such bills for emergency care and non-emergency services at in-network facilities. It is crucial to request a full itemized billing audit before paying any invoice, as summary bills often obscure errors or unbundled codes that could be