Electrocardiogram (EKG, tracing only)
Facility: Lane County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $185
- Cash Discount Price: $168
- vs. Medicare Baseline: 3.07x 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 307% of the Medicare baseline (a markup of 207%). 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 |
|---|---|---|
| Aetna | $104 - $209 | 173% |
| UnitedHealthcare | $104 - $220 | 173% |
| Healthy Blue Mcr Adv - All Other Plans | $115 - $220 | 191% |
| Medicaid / KanCare | $115 - $242 | 191% |
| Healthy Blue Mcaid | $115 - $220 | 191% |
| Wppa Providers-All Plans | $172 - $330 | 285% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) procedure at Lane County Hospital in Dighton, Kansas, the cash price is $168.00, which matches the facility's median negotiated rate. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $104 to $242, these amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans. It is important to note that commercial rates can be inflated by administrative costs and contract structures, sometimes reaching 200% to 300% of the Medicare benchmark of $60.27, whereas fair pricing is typically defined as 120% to 150% of this baseline. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may be unnecessary if they have not yet met their out-of-pocket threshold.
To ensure you are not overcharged, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a summary bill, insist on a detailed CPT-coded statement to identify any services not rendered or charges that should be bundled. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. If you encounter a balance bill from an out-of-network provider at this in-network facility, remember that the No Surprises Act protects you from being billed for emergency or non-emergency services from out