Electrocardiogram (EKG, tracing only)
Facility: Stafford County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $229
- Cash Discount Price: $229
- vs. Medicare Baseline: 3.80x 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 380% of the Medicare baseline (a markup of 280%). 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 |
|---|---|---|
| Health Partners-All Plans | $209 - $261 | 347% |
| UnitedHealthcare | $220 - $275 | 365% |
| Medica Mcr- All Plans | $220 - $275 | 365% |
| Humana | $220 - $275 | 365% |
| Va Ccn-All Plans | $220 - $275 | 365% |
Consumer Guidance & Cost Commentary
For the CPT code 93005, Electrocardiogram (EKG, tracing only), Stafford County Hospital lists a cash price of $229.00, which matches the median negotiated rate across all five major payers including Health Partners, UnitedHealthcare, and Humana. While the facility's cash price is identical to the median negotiated amount, it is important to note that commercial insurance plans often pay significantly higher rates than cash prices due to administrative overhead and contract structures. In this specific case, the median allowed amount paid by insurers is $261.00, meaning patients with high-deductible plans might save money by paying the $229.00 cash price directly, provided they have not yet met their deductible.
The facility's pricing is benchmarked against the Medicare rate of $60.27, showing a markup of 3.8 times the federal baseline, which falls within the typical range for commercial negotiations. As a Critical Access Hospital in Stafford, KS, the facility offers a self-pay rate of $229.00, and patients should explicitly ask about "prompt-pay" discounts or self-pay classifications before scheduling to ensure they are not billed the full chargemaster rate. Since the cash price is lower than the insurer's allowed amount, patients should verify their plan's deductible status and consider paying out-of-pocket to avoid balance billing or unexpected secondary charges, especially if the service is not an emergency.