Electrocardiogram (EKG, tracing only)
Facility: Wamego Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $22
- Cash Discount Price: $72
- vs. Medicare Baseline: 0.37x 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.
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 |
|---|---|---|
| Providrs Care | $7 | 12% |
| Medicaid / KanCare | $15 - $22 | 25% |
| UnitedHealthcare | $21 | 35% |
| Aetna | $22 | 37% |
| Tricare | $27 | 45% |
| Blue Cross Blue Shield | $216 - $227 | 358% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG) service at Wamego Health Center, the cash price of $72.00 is significantly lower than the facility's gross charge of $181.00 and the Medicare benchmark of $60.27. While the cash rate is higher than the Medicare amount, it remains well below the negotiated rates paid by major insurers such as Blue Cross Blue Shield, which range from $216 to $227. This disparity highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. Patients should verify their specific plan details, as paying cash upfront may be more cost-effective than relying on insurance coverage that triggers higher negotiated fees.
To minimize potential financial exposure, consumers should proactively request a "self-pay" or "prompt-pay" discount from the facility before scheduling, as these programs can reduce the final bill by 20% to 50%. Additionally, if you are covered by insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network providers at in-network facilities, and you should never sign away your rights to dispute surprise bills without reading the consent forms carefully. Finally, always demand a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered that can be corrected through a formal written audit dispute.