Electrocardiogram (EKG, tracing only)
Facility: Greenwood County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $220
- Cash Discount Price: $208
- vs. Medicare Baseline: 3.65x 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 365% of the Medicare baseline (a markup of 265%). 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 |
|---|---|---|
| Triwest - All Plans | $93 | 154% |
| UnitedHealthcare | $109 - $218 | 181% |
| Choicecare Mcr Adv - All Plans | $109 | 181% |
| Tricare | $109 | 181% |
| Blue Cross Blue Shield | $155 - $163 | 257% |
| Integrated Health Plan - All Plans | $195 | 324% |
| Beech Street - All Plans | $221 | 367% |
| First Health - All Other Plans | $221 | 367% |
| First Health Ccn Network | $221 | 367% |
| Preferred Hs (Coventry) - All Plans | $234 | 388% |
| Principal Health Care Inc - All Plans | $247 | 410% |
| Amerigroup Mcaid-All Plans | $260 | 431% |
| Medicaid / KanCare | $260 | 431% |
| Providrs Care/Wppa - All Plans | $390 | 647% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Greenwood County Hospital in Eureka, Kansas, the facility's cash price of $208 is lower than the state average of $218, making it a competitive option for self-pay patients. However, commercial insurance plans typically pay significantly more than the cash rate; for instance, UnitedHealthcare and Choicecare Mcr Adv have negotiated rates ranging from $109 to $218, while Amerigroup and Medicaid pay the full gross amount of $260. Because commercial negotiated rates often exceed cash prices, patients with high-deductible plans may save money by paying the cash price directly, provided they can afford the upfront cost. It is important to note that while the facility is a Critical Access Hospital with government local ownership, patients should verify their specific plan's allowed amount before scheduling to ensure they are not subject to balance billing if they are out-of-network, though the No Surprises Act protects emergency care at in-network facilities.
Patients should be aware that insurance companies often pay less than the facility's gross charge, which can result in balance billing if the patient is out-of-network, though federal protections limit this for emergency services. Even for in-network patients, it is crucial to request an itemized billing audit before paying any final invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, since the facility offers prompt-pay discounts for upfront payment, patients should ask for a self-pay classification and potential discount at registration rather than waiting until after receiving a large insurance bill. By comparing the cash price of $208 against the Medicare benchmark of $60.27,