Electrocardiogram (EKG, tracing only)
Facility: Rawlins County Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $287
- Cash Discount Price: $281
- vs. Medicare Baseline: 4.76x 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 476% of the Medicare baseline (a markup of 376%). 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 | $164 | 272% |
| UnitedHealthcare | $287 | 476% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Rawlins County Health Center in Atwood, Kansas, the cash price is $281, which is lower than the facility's negotiated rate of $287. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead and contract dynamics. In this specific case, the cash price is actually lower than the negotiated amount, meaning patients with high-deductible plans or those without insurance may save money by paying directly. However, if your insurance plan has a deductible that has not yet been met, you may still be responsible for the full negotiated amount, which is $287, rather than the cash price.
To ensure you are not overcharged, it is important to distinguish between the facility's gross charge of $330 and the actual amounts billed to insurers. The Medicare benchmark for this service is $60.27, which serves as a baseline for evaluating pricing fairness; commercial negotiated rates typically range from 200% to 300% of Medicare, while fair pricing is often defined between 120% and 150%. If you receive a bill that includes unexpected charges beyond the negotiated rate, you may be facing balance billing, which is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act. Before finalizing payment, we strongly recommend requesting a full itemized bill to verify that no unbundled codes or services not rendered have been included, and asking the billing department specifically about any available self-pay or prompt-pay discounts that could further reduce your out-of-pocket costs.