Electrocardiogram (EKG, tracing only)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $156
- Cash Discount Price: $219
- vs. Medicare Baseline: 2.59x 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 259% of the Medicare baseline (a markup of 159%). 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 |
|---|---|---|
| Humana | $5 - $58 | 8% |
| Medicaid / KanCare | $5 - $57 | 8% |
| Aetna | $5 - $57 | 8% |
| Provider Partners Health Plans Contracted [320450] | $6 | 10% |
| First Health Contracted [320128] | $7 | 12% |
| Blue Cross Blue Shield | $21 - $123 | 35% |
| UnitedHealthcare | $51 - $312 | 85% |
| Globalhealth Contracted [320145] | $57 | 95% |
| Medicare (plans) | $57 | 95% |
| Medical Associates Health Contracted [320444] | $57 | 95% |
| Mercy Hospice Okc [20252] | $57 | 95% |
| Elara Caring Aspire Hospice [20433] | $57 | 95% |
| Halo Hcr Inc Hospice [20432] | $57 | 95% |
| Pace Of The Ozarks Contracted [320518] | $57 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $57 | 95% |
| Qual Choice Contracted [320325] | $57 | 95% |
| Kindful Hospice [20434] | $57 | 95% |
| Tricare | $57 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $57 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $57 | 95% |
| Kindful Hospice Contracted [320434] | $57 | 95% |
| Cigna | $57 - $259 | 95% |
| Cross Timbers Hospice [20098] | $57 | 95% |
| Centivo Contracted [320505] | $58 | 96% |
| Dept Of Veteran Affairs Contracted [320106] | $58 | 96% |
| Providrs Care Network Contracted [320484] | $110 | 183% |
| Medica Contracted [320239] | $123 | 204% |
| United Medical Resources Contracted [320454] | $156 - $253 | 259% |
| Point C Contracted [320238] | $168 - $253 | 279% |
| Show-Me Health Administrators Contracted [320483] | $202 | 335% |
| Mercy Benefit Admin Contracted [320251] | $202 - $236 | 335% |
| Yuzu Health Contracted [320521] | $236 | 392% |
| Aither Health Contracted [320449] | $236 | 392% |
| Ebms Contracted [320493] | $236 | 392% |
| Imagine 360 Contracted [320494] | $236 | 392% |
| Reflect Health Contracted [320492] | $236 | 392% |
| Auxiant Contracted [320462] | $236 - $253 | 392% |
| American Healthcare Alliance Contracted [320020] | $236 | 392% |
| Edison Health Solutions Contracted [320502] | $236 | 392% |
| Healthlink Contracted [320179] | $253 | 420% |
| Preferred Health Plan Contracted [320522] | $253 | 420% |
| Benefit Management Contracted [320052] | $253 | 420% |
| Health Systems Inc Contracted [320174] | $253 | 420% |
| Federal Medical Center Contracted [320127] | $253 | 420% |
| Insurance System Inc Contracted [320465] | $253 | 420% |
| Healthscope Contracted [320182] | $253 | 420% |
| Compcare Of The Ozarks Contracted [320437] | $266 | 441% |
| Workers Comp [20426] | $270 | 448% |
| Private Health Care Systems Contracted [320320] | $312 | 518% |
| Multiplan [20270] | $320 | 531% |
| Multiplan Contracted [320270] | $320 | 531% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Mercy Specialty Hospital Southeast Kansas, the facility's cash price of $219.00 is notably higher than the state average of $123.00, though it remains below the gross chargemaster rate of $337.00. While many commercial payers negotiate rates ranging from $5 to $320, the Medicare benchmark of $60.27 serves as the most reliable baseline for understanding true costs, indicating that commercial negotiated rates often exceed the federal standard. Patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rates are significantly higher than $219.00, as paying out-of-pocket could result in immediate savings compared to the administrative overhead embedded in insurance billing.
To maximize potential savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly claims processing. It is also important to verify the specific allowed amount for your insurance plan, as in-network rates vary widely across the 51 payers listed, with some contracts reaching up to $320.00. Finally, if you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit to ensure accuracy, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.