Electrocardiogram (EKG, tracing only)
Facility: Kansas City Orthopaedic Institute
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $131
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.17x 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 217% of the Medicare baseline (a markup of 117%). 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 |
|---|---|---|
| UnitedHealthcare | $54 | 90% |
| Aetna | $54 | 90% |
| Cigna | $56 - $187 | 93% |
| Blue Cross Blue Shield | $131 - $239 | 217% |
| Medica | $205 | 340% |
Consumer Guidance & Cost Commentary
For the CPT code 93005, Electrocardiogram (EKG, tracing only), the Kansas City Orthopaedic Institute in Leawood, KS, has a negotiated rate of $131.00, which is significantly higher than the state average of $131.00 and the county average of $131.00. While the facility's negotiated rates align with local averages, patients should be aware that cash-pay options are often more affordable for those with high-deductible plans, as commercial insurance negotiated rates frequently exceed cash prices. The facility offers a prompt-pay discount for upfront payments, which can bypass the administrative costs associated with insurance claims processing and provide immediate liquidity benefits.
It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like laboratory tests are billed separately. Patients should request a full itemized CPT-coded bill before paying to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes. Additionally, verifying your deductible status before scheduling is crucial, as paying the negotiated rate without meeting your plan's deductible can result in higher out-of-pocket costs than anticipated.