Electrocardiogram (ECG/EKG)
Facility: Holton Community Hospital
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $36
- Cash Discount Price: $33
- vs. Medicare Baseline: 2.34x 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 234% of the Medicare baseline (a markup of 134%). 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 |
|---|---|---|
| UnitedHealthcare | $23 - $31 | 150% |
| Humana | $23 | 150% |
| Aetna | $23 - $44 | 150% |
| Kansas Superior Select - All Plans | $24 | 156% |
| Preferred Health Professionals | $36 | 234% |
| Preferred Health Fn Select - All Other Plans | $36 | 234% |
| Preferred Health Freedom | $36 | 234% |
| Wppa Providers - All Plans | $42 | 273% |
| Medicaid / KanCare | $44 | 286% |
Consumer Guidance & Cost Commentary
For an Electrocardiogram (ECG/EKG) at Holton Community Hospital in Holton, KS, the cash price is $33.00, which matches the median amount paid by insurance plans. This rate is significantly lower than the facility's gross charge of $44.00 and aligns closely with the state average for this procedure. While Medicare reimburses $15.36 for this service, commercial insurance contracts typically result in higher payments; for instance, UnitedHealthcare and Humana pay between $23.00 and $31.00, while Aetna's range extends up to $44.00. Patients with high-deductible plans should consider paying the $33.00 cash rate directly, as it avoids potential balance billing if their insurance allowed amount exceeds this figure, though federal protections like the No Surprises Act may limit such billing for out-of-network services at in-network facilities.
To minimize costs, patients should verify if the hospital offers a "prompt-pay" discount for upfront payment, which can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. It is also critical to request a full itemized bill before agreeing to any payment plan, as summary bills often obscure unbundled charges or services not rendered, leading to unexpected debt. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, comparing the negotiated rates against the Medicare benchmark of $15.36 reveals that commercial contracts often include administrative markups. Consumers are advised to check their specific plan's deductible status and network tiering before scheduling, ensuring they understand whether their insurance will cover the full negotiated amount