Electrocardiogram (EKG, tracing only)
Facility: Rooks County Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $235
- Cash Discount Price: $196
- vs. Medicare Baseline: 3.90x 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 390% of the Medicare baseline (a markup of 290%). 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 |
|---|---|---|
| Celtic Mcr Adv | $123 | 204% |
| Tricare | $123 | 204% |
| Veterans Admin - All Plans | $123 | 204% |
| Celtic Comm - All Other Plans | $135 | 224% |
| Blue Cross Blue Shield | $164 | 272% |
| Preferred Benefits Admin | $235 | 390% |
| Aetna | $235 | 390% |
| UnitedHealthcare | $235 | 390% |
| Health Partners - All Plans | $248 | 411% |
| Preferred Hlthcare - All Other Plans | $248 | 411% |
| Healthy Blue Mcaid - All Plans | $262 | 435% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Rooks County Health Center in Plainville, KS, the facility's cash price of $196.00 is notably higher than the state average of $135.00, though it remains below the gross chargemaster rate of $262.00. While commercial insurance negotiates a median rate of $235.00, which exceeds the cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount surpasses the cash rate. It is important to note that the facility, a Critical Access Hospital owned by a Government Hospital District, lists a cash median of $196.00, which serves as a baseline for self-pay patients.
Patients should be aware that commercial payers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield have negotiated rates ranging from $123 to $262, with most falling between $235 and $248. Because these negotiated rates often include administrative overhead and do not reflect the true cost of care, comparing them directly to the Medicare benchmark of $60.27 reveals significant markups. To minimize costs, consumers should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the higher insurance negotiated rates. Additionally, if a patient receives a bill exceeding the allowed amount, they should request an itemized audit to verify that no balance billing or unbundled charges are included, ensuring they are only paying for services rendered at the agreed-upon rate.