Electrocardiogram (ECG/EKG)
Facility: Hiawatha Community Hospital
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $77
- Cash Discount Price: $81
- vs. Medicare Baseline: 5.01x 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 501% of the Medicare baseline (a markup of 401%). 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 |
|---|---|---|
| Centrus Health Direct - All Plans | $61 | 397% |
| Oscar - All Plans | $61 | 397% |
| Aetna | $65 - $257 | 423% |
| Blue Cross Blue Shield | $69 - $73 | 449% |
| Preferred Hlth - All Plans | $73 | 475% |
| Cigna | $77 | 501% |
| Wppa Providrs Care - All Plans | $77 | 501% |
| Multiplan - All Plans | $79 | 514% |
| Midlands Choice - All Plans | $79 | 514% |
| Healthy Blue Mcaid - All Plans | $81 | 527% |
| Humana | $257 | 1673% |
| Ambetter / Centene | $270 | 1758% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (ECG/EKG) service at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $81.00, which matches the facility's gross charge. This rate is significantly higher than the state average for this procedure, which is $69.00. While commercial insurance plans like Aetna and Humana have negotiated rates ranging from $61 to $270, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $81.00 directly, as this avoids potential out-of-pocket costs if their insurance deductible has not yet been met.
To potentially lower the cost, patients should inquire about "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims. It is also important to request an itemized billing audit before paying, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. Finally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their specific plan details and ask the hospital to classify the service as self-pay to ensure they receive the most favorable rate available.