Electrocardiogram (EKG, tracing only)
Facility: Nemaha Valley Community Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $105
- Cash Discount Price: $122
- vs. Medicare Baseline: 1.74x 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.
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 |
|---|---|---|
| Humana | $19 - $99 | 32% |
| Partners Direct Health - All Plans | $23 - $118 | 38% |
| Aetna | $37 - $329 | 61% |
| Multiplan - All Plans | $40 - $203 | 66% |
| Midlands Choice - All Plans | $42 - $215 | 70% |
| Health Partners - All Plans | $42 - $215 | 70% |
| Va Ccn - All Plans | $99 | 164% |
| Celtic Comm Exch - All Plans | $109 - $329 | 181% |
| Blue Cross Blue Shield | $164 | 272% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) procedure at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median price is $122.00, which is notably higher than the state average of $104.00. While commercial insurance plans like Humana and Partners Direct Health have negotiated rates ranging from $19 to $118, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about self-pay or prompt-pay discounts before scheduling to ensure they are not overpaying due to administrative fees or network tiering.
The facility's Medicare benchmark rate of $60.27 serves as a critical baseline for evaluating pricing fairness, as commercial negotiated rates frequently run 200% to 300% above this figure. In this case, the median negotiated rate of $105.00 aligns closely with the state median paid amount, suggesting the facility is pricing within a reasonable range relative to the region. However, patients should avoid accepting summary bills as final invoices and instead request a detailed, itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. By comparing rates strictly against the Medicare benchmark rather than the inflated chargemaster list, consumers can better understand the true cost of care and negotiate more effectively with the hospital.