Electrocardiogram (ECG/EKG)
Facility: Clara Barton Hospital
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $339
- Cash Discount Price: $264
- vs. Medicare Baseline: 22.07x 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 2207% of the Medicare baseline (a markup of 2107%). 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 |
|---|---|---|
| 6 Degrees Health - All Plans | $264 | 1719% |
| Wppa-All Plans | $302 | 1966% |
| UnitedHealthcare | $339 | 2207% |
| Phcs - All Plans | $339 | 2207% |
| Aetna | $339 | 2207% |
| Hlth Partners Of Ks-All Plans | $347 | 2259% |
Consumer Guidance & Cost Commentary
For the CPT code 93000, Electrocardiogram (ECG/EKG), Clara Barton Hospital in Hoisington, KS, has a cash median price of $264.00, which is lower than the facility's negotiated rates of $339.00 paid by six major payers including UnitedHealthcare and Aetna. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that paying cash upfront may result in significant savings compared to insurance billing, as the negotiated rates often exceed the cash price. To maximize savings, individuals with high-deductible plans should verify if their specific insurance plan's allowed amount exceeds the cash rate, and they should explicitly request a "self-pay" or "prompt-pay" discount before scheduling to avoid automatic claim submission that could void any cash agreement.
The facility's pricing is benchmarked against federal standards, with a Medicare amount of $15.36, indicating that the cash rate of $264.00 represents a substantial markup over the government baseline. Although the data does not provide specific state or county average comparisons for this service, the consistent negotiated rates across all six payers suggest a uniform pricing strategy typical for in-network contracts. Consumers are advised to review their itemized bills carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Always confirm your deductible status before relying on insurance, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying the cash price directly.