Electrocardiogram (EKG, tracing only)
Facility: Holton Community Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $208
- Cash Discount Price: $186
- vs. Medicare Baseline: 3.45x 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 345% of the Medicare baseline (a markup of 245%). 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 | $130 - $290 | 216% |
| Aetna | $130 - $290 | 216% |
| Humana | $131 - $155 | 217% |
| Kansas Superior Select - All Plans | $132 - $157 | 219% |
| Preferred Health Freedom | $203 - $241 | 337% |
| Preferred Health Professionals | $203 - $241 | 337% |
| Preferred Health Fn Select - All Other Plans | $203 - $241 | 337% |
| Wppa Providers - All Plans | $233 - $276 | 387% |
| Medicaid / KanCare | $245 - $290 | 407% |
Consumer Guidance & Cost Commentary
For the CPT code 93005, Electrocardiogram (EKG, tracing only), Holton Community Hospital in Holton, KS, lists a cash price of $186.00, which is lower than the facility's gross charge of $248.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, UnitedHealthcare and Aetna have negotiated ranges starting at $130 and going up to $290, while Medicaid/KanCare ranges from $203 to $241. In cases where a patient has a high deductible or no coverage, paying the cash price of $186.00 directly may result in significant savings compared to the allowed amounts paid by insurers, provided the patient qualifies for self-pay or prompt-pay discounts.
The facility's cash rate of $186.00 is notably higher than the national Medicare benchmark of $60.27, reflecting the true cost of service delivery adjusted for local wage indexes and provider expenses. However, it is important to distinguish this from the gross chargemaster, which is often inflated to make discounts appear larger; fair pricing typically aligns closer to the 120% to 150% of Medicare range rather than the full list price. To ensure transparency and avoid balance billing, patients should request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, if a patient receives care from an out