Electrocardiogram (EKG, tracing only)
Facility: Ashland Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $229
- Cash Discount Price: $183
- vs. Medicare Baseline: 3.80x 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 380% of the Medicare baseline (a markup of 280%). 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 | $77 | 128% |
| Compalliance-All Plans | $183 | 304% |
| Health Partners Of Kansas-All Plans | $195 | 324% |
| Multiplan-All Plans | $224 | 372% |
| Medicaid / KanCare | $229 | 380% |
| Healthy Blue Mcr Adv - All Other Plans | $229 | 380% |
| Medicare (plans) | $229 | 380% |
| UnitedHealthcare | $229 | 380% |
| Health Choice-All Plans | $229 | 380% |
| Medica Mcare - All Plans | $229 | 380% |
| Aetna | $229 | 380% |
| Providers Care (Wppa)-All Plans | $344 | 571% |
Consumer Guidance & Cost Commentary
For the CPT code 93005, Electrocardiogram (EKG, tracing only), the facility's negotiated rates range from $77 to $344, with a median negotiated amount of $229. This median rate is notably higher than the cash price of $183 and exceeds the Medicare benchmark of $60.27 by 3.8 times. While the facility is a Critical Access Hospital in Ashland, KS, the data provided does not include specific state or county average figures for comparison. Patients should be aware that commercial insurance contracts often result in higher costs than cash payments due to administrative overhead and contract dynamics; however, if a patient has a high deductible plan, paying the cash price of $183 upfront could save money compared to the $229 median negotiated rate, provided they have not yet met their deductible.
To minimize costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. It is also important to request a full itemized bill before agreeing to payment terms, as summary bills may obscure errors or unbundled charges. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their plan's network status and deductible status before scheduling. Finally, since the facility is a voluntary non-profit, patients should confirm whether their specific insurance plan is in-network to ensure they are protected from unexpected out-of-pocket expenses.