Electrocardiogram (EKG, tracing only)
Facility: Grisell Memorial Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $238
- Cash Discount Price: $259
- vs. Medicare Baseline: 3.95x 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 395% of the Medicare baseline (a markup of 295%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $155 | 257% |
| UnitedHealthcare | $203 - $273 | 337% |
| Medicaid / KanCare | $273 | 453% |
| Humana | $273 | 453% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Grisell Memorial Hospital in Ransom, KS, the facility's cash median price of $259.00 is lower than the state average of $273.00, making it a cost-effective option for self-pay patients. While the facility's negotiated rates with commercial insurers like UnitedHealthcare and Humana range up to $273.00, these amounts often exceed the cash price, which can be advantageous for patients with high-deductible plans who may not yet have met their out-of-pocket limits. It is important to note that Medicaid/KanCare and Blue Cross Blue Shield have fixed negotiated rates of $155.00 and $155.00 respectively, which are significantly lower than both the cash and commercial negotiated rates, highlighting how insurance contracts can sometimes result in lower out-of-pocket costs than paying directly.
When comparing this facility's pricing to the broader healthcare landscape, the Medicare benchmark amount of $60.27 serves as the objective baseline for evaluating the markup on this service. The facility's cash rate of $259.00 represents a substantial increase over the Medicare rate, illustrating the typical administrative and operational costs embedded in commercial billing structures. Patients should be aware that while the facility is a Critical Access Hospital owned by a Government Hospital District, they should actively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing the administrative overhead associated with insurance claims processing.