Electrocardiogram (EKG, tracing only)
Facility: Kansas Medical Center Llc
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $54
- Cash Discount Price: $130
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Medicaid / KanCare | $21 | 35% |
| Tricare | $49 | 81% |
| Indian Health | $49 | 81% |
| Humana | $54 | 90% |
| Ambetter / Centene | $54 | 90% |
| Medadv_Wellcare | $54 | 90% |
| Blue Cross Blue Shield | $54 - $157 | 90% |
| Wppa | $87 | 144% |
| Aetna | $97 | 161% |
| Three_Rivers | $109 | 181% |
| United | $180 | 299% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Kansas Medical Center Llc in Andover, KS, the cash price is $130.00, while the median negotiated rate across insurance plans is $54.00. This indicates that paying out-of-pocket directly can be significantly more expensive than using an in-network insurance plan, as the facility's cash rate exceeds the average amount insurers agree to pay. However, patients with high-deductible plans should consider that if their insurance allowed amount exceeds the cash price, paying the cash rate of $130.00 upfront might result in lower out-of-pocket costs compared to the insurance process. It is crucial to verify your specific plan's allowed amount before scheduling, as some commercial rates can vary widely; for instance, Blue Cross Blue Shield has a range of $54.00 to $157.00, while others like Medicaid / KanCare and Tricare are fixed at $21.00 and $49.00 respectively.
The facility's pricing relative to Medicare benchmarks shows a gross charge of $217.00, which is 3.6 times the Medicare amount of $60.27, highlighting the potential for significant markups on chargemaster lists. While the median negotiated rate of $54.00 is lower than the cash price, patients should be aware that balance billing could occur if they receive care from out-of-network providers or ancillary services not covered by the No Surprises Act protections. To minimize costs, consumers should request a prompt-pay discount before check-in, which can reduce the bill by 20% to 50% if paid in full