Electrocardiogram (EKG, tracing only)
Facility: Hamilton County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $130
- Cash Discount Price: $133
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 | $77 - $164 | 128% |
| First Health Coventry - All Plans | $113 | 187% |
| UnitedHealthcare | $126 | 209% |
| Cigna | $126 | 209% |
| Va Ccn - All Plans | $133 | 221% |
| Aetna | $226 | 375% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Hamilton County Hospital in Syracuse, KS, the cash price is $133.00, which matches the facility's negotiated rate for all six insurance payers listed. While commercial insurance plans typically pay significantly less than the cash price due to administrative overhead and contract structures, paying out-of-pocket can sometimes result in lower total costs for patients with high deductibles. The facility, a Critical Access Hospital owned by the local government, does not offer a specific discount percentage in this report, but patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the bill.
When evaluating the cost, it is important to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this procedure is $60.27, and the facility's cash rate of $133.00 represents a markup of 2.2 times the Medicare rate. This aligns with the typical range where fair pricing is often defined between 120% and 150% of Medicare, though commercial negotiated rates can sometimes exceed 300%. To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices may hide unbundled codes or services not rendered. If you receive a balance bill from an out-of-network provider, you may be eligible for protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities.