Electrocardiogram (EKG, tracing only)
Facility: Stevens County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $239
- Cash Discount Price: $275
- vs. Medicare Baseline: 3.97x 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 397% of the Medicare baseline (a markup of 297%). 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 |
|---|---|---|
| Humana | $102 | 169% |
| Aetna | $105 - $275 | 174% |
| Blue Cross Blue Shield | $156 - $164 | 259% |
| First Health - All Plans | $248 | 411% |
| Wppa - All Plans | $261 | 433% |
| Medicaid / KanCare | $275 | 456% |
Consumer Guidance & Cost Commentary
For the CPT code 93005 (Electrocardiogram), Stevens County Hospital in Hugoton, KS, lists a cash price of $275.00, which matches the facility's gross charge and the median cash rate reported for this service. While the facility is a Critical Access Hospital with government local ownership, the negotiated rates vary significantly by payer; for instance, Aetna plans range from $105 to $275, whereas Medicaid/KanCare is set at $275. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures, meaning patients with high-deductible plans might save money by paying cash directly, provided they have no other coverage. Before scheduling, patients should explicitly request self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid upfront, effectively bypassing the costly insurance claims processing cycle.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $60.27, and the facility's negotiated median rate of $239.00 represents a significant markup relative to this federal baseline. Additionally, the median paid amount across all payers is $102.00, which is substantially lower than the cash price, illustrating how insurance contracts can result in lower out-of-pocket costs for insured members compared to cash payers. Patients should avoid accepting summary bills that obscure individual line items and instead demand a detailed itemized statement to ensure no unbundled charges or services not rendered are included, as