Electrocardiogram (ECG/EKG)
Facility: Nemaha Valley Community Hospital
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $243
- Cash Discount Price: $243
- vs. Medicare Baseline: 15.82x 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 $15.36 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 1582% of the Medicare baseline (a markup of 1482%). 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 | $31 | 202% |
| Humana | $119 | 775% |
| Partners Direct Health - All Plans | $140 | 911% |
| Aetna | $230 - $329 | 1497% |
| Multiplan - All Plans | $243 | 1582% |
| Midlands Choice - All Plans | $256 | 1667% |
| Health Partners - All Plans | $256 | 1667% |
| Celtic Comm Exch - All Plans | $329 | 2142% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (ECG/EKG) procedure at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $243.00, which matches the facility's median negotiated rate. This aligns closely with the state average for this service, as the cash median is identical to the median negotiated amount listed in the data. While commercial payers like Aetna and Multiplan have negotiated rates ranging from $230 to $329, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $243.00. To ensure you receive the best possible rate, it is recommended to explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your appointment, as these upfront payment incentives can further reduce the final cost.
When reviewing your final bill, it is crucial to request a detailed, itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing your facility's pricing to the Medicare benchmark provides a clear view of the true cost baseline; for this procedure, the Medicare amount is $15.36, and the facility's cash rate is approximately 15.8% higher than this federal standard. This comparison helps identify if the commercial rates are appropriately marked up or inflated. If you receive a large bill after insurance processing, do not pay immediately; instead, request a formal written audit dispute to correct any potential overcharges or balance billing issues, ensuring you are only responsible for the accurate, contracted amount.