Electrocardiogram (EKG, tracing only)
Facility: Kiowa District Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $217
- Cash Discount Price: $184
- vs. Medicare Baseline: 3.60x 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 360% of the Medicare baseline (a markup of 260%). 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 |
|---|---|---|
| Tricare | $90 | 149% |
| Healthchoice-All Plans | $94 | 156% |
| Blue Cross Blue Shield | $163 | 270% |
| UnitedHealthcare | $184 - $230 | 305% |
| Health Partners Of Ks-All Plans | $202 | 335% |
| Humana | $208 | 345% |
| Multiplan-All Plans | $216 | 358% |
| Gbs Insurance - All Plans | $216 | 358% |
| Triwest-All Plans | $218 | 362% |
| Medicare (plans) | $218 | 362% |
| Aetna | $218 | 362% |
| Medicaid / KanCare | $230 | 382% |
| Providers Care (Wppa)-All Plans | $345 | 572% |
| Liberty Healthshare-All Plans | $371 | 616% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) service at Kiowa District Hospital in Kiowa, Kansas, the cash price is $184.00, which is lower than the facility's negotiated rates with most major payers. While the facility is a Critical Access Hospital with government ownership, patients should be aware that commercial insurance contracts often result in higher allowed amounts than cash prices; for instance, UnitedHealthcare's negotiated range spans from $184 to $230, and UnitedHealthcare's average allowed amount is $216.00. In this specific case, paying cash directly may save money compared to using insurance, provided the patient's plan has a high deductible or the negotiated rate exceeds the cash price. However, patients should always verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
The facility's cash rate of $184.00 is notably lower than the median negotiated rate of $216.00 and the median negotiated rate of $217.00 reported for this service. When comparing to federal benchmarks, the Medicare amount for this procedure is $60.27, which serves as a baseline for evaluating the facility's pricing markup. 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 review their itemized bills carefully to ensure no unbundled codes or services not rendered are included. If a patient receives a bill that appears higher than expected, they should request a formal itemized audit to identify