Electrocardiogram (EKG, tracing only)
Facility: Mercy Hospital Columbus
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $179
- Cash Discount Price: $154
- vs. Medicare Baseline: 2.97x 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 297% of the Medicare baseline (a markup of 197%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $2 | 3% |
| Medicaid / KanCare | $5 - $172 | 8% |
| Humana | $5 - $225 | 8% |
| UnitedHealthcare | $51 - $197 | 85% |
| Blue Cross Blue Shield | $51 - $214 | 85% |
| Medicare (plans) | $56 - $179 | 93% |
| Health Systems Inc Contracted [320174] | $102 | 169% |
| Insurance System Inc Contracted [320465] | $102 | 169% |
| Administrative Payor Contracted [320005] | $107 | 178% |
| Qual Choice Contracted [320325] | $172 | 285% |
| Novasys Contracted [320285] | $172 | 285% |
| Pace Of The Ozarks Contracted [320518] | $172 | 285% |
| Home State Health Plan Contracted [320187] | $172 | 285% |
| Cigna | $172 | 285% |
| Ambetter / Centene | $172 | 285% |
| Halo Hcr Inc Hospice Contracted [320432] | $172 | 285% |
| Cherokee Nation Health Serv Contracted [320066] | $172 | 285% |
| Elara Caring Aspire Hospice [20433] | $172 | 285% |
| Indian Health Service Contracted [320198] | $172 | 285% |
| Provider Partners Health Plans Contracted [320450] | $172 | 285% |
| Cross Timbers Hospice [20098] | $172 | 285% |
| Medical Associates Health Contracted [320444] | $172 | 285% |
| Aetna | $172 - $213 | 285% |
| Centurion Of Missouri [20459] | $172 | 285% |
| Mercy Mgd Behavioral Health Contracted [320259] | $172 | 285% |
| Kindful Hospice [20434] | $172 | 285% |
| Mercy Hospice Okc [20252] | $172 | 285% |
| Kindful Hospice Contracted [320434] | $172 | 285% |
| Globalhealth Contracted [320145] | $172 | 285% |
| Dept Of Veteran Affairs Contracted [320106] | $172 | 285% |
| Halo Hcr Inc Hospice [20432] | $172 | 285% |
| Tricare | $173 | 287% |
| Healthscope Contracted [320182] | $183 | 304% |
| Workers Comp [20426] | $190 - $201 | 315% |
| United Medical Resources Contracted [320454] | $197 - $225 | 327% |
| Medica Contracted [320239] | $212 | 352% |
| Preferred Health Plan Contracted [320522] | $213 | 353% |
| Healthlink Contracted [320179] | $213 - $225 | 353% |
| First Health Contracted [320128] | $213 | 353% |
| Federal Medical Center Contracted [320127] | $213 | 353% |
| Usa Managed Care Org Contracted [320429] | $213 | 353% |
| American Healthcare Alliance Contracted [320020] | $213 | 353% |
| Mercy Benefit Admin Contracted [320251] | $213 - $225 | 353% |
| Reflect Health Contracted [320492] | $225 | 373% |
| Auxiant Contracted [320462] | $225 | 373% |
| Imagine 360 Contracted [320494] | $225 | 373% |
| Aither Health Contracted [320449] | $225 | 373% |
| Benefit Management Contracted [320052] | $225 | 373% |
| Point C Contracted [320238] | $225 | 373% |
| Ebms Contracted [320493] | $225 | 373% |
| Ppo Plus Contracted [320310] | $225 | 373% |
| Edison Health Solutions Contracted [320502] | $225 | 373% |
| Yuzu Health Contracted [320521] | $225 | 373% |
| Private Health Care Systems Contracted [320320] | $225 | 373% |
| 90 Degree Benefits Contracted [320436] | $225 | 373% |
| Show-Me Health Administrators Contracted [320483] | $225 | 373% |
Consumer Guidance & Cost Commentary
For a self-pay patient, the most immediate financial advantage is that the cash median rate of $154 is significantly lower than the standard negotiated rates charged by insurance plans. While many commercial payers, including Medicaid/KanCare and major carriers like Humana and UnitedHealthcare, are contractually bound to pay between $172 and $225 for this procedure, paying cash directly allows patients to bypass these higher administrative fees. This price difference can be substantial, especially for those with high-deductible plans where the insurance allowed amount might exceed the cash price; however, patients should verify with the hospital whether a "prompt-pay" discount is available to further reduce the final balance before scheduling.
The broader rate context for this electrocardiogram (EKG) service at Mercy Hospital Columbus shows a wide variance, with the gross chargemaster listed at $237 and the facility's cash median at $154. It is important to note that while the cash rate is lower than the majority of negotiated rates, it remains higher than the Medicare benchmark of $60.27, which serves as the federal cost baseline for this service. Patients should be aware that commercial negotiated rates often include overhead costs for claims processing and utilization review, which can inflate the final price compared to direct cash payment. Additionally, because this is a Critical Access Hospital in Kansas, patients should confirm their specific plan's coverage and any potential self-pay discounts before receiving care to avoid unexpected balance billing or surprise costs.