Electrocardiogram (EKG, tracing only)
Facility: Hiawatha Community Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $160
- Cash Discount Price: $253
- vs. Medicare Baseline: 2.65x 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 265% of the Medicare baseline (a markup of 165%). 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 |
|---|---|---|
| UnitedHealthcare | $13 - $405 | 22% |
| Humana | $13 - $176 | 22% |
| Aetna | $13 - $381 | 22% |
| Ambetter / Centene | $16 - $209 | 27% |
| Centrus Health Direct - All Plans | $26 - $353 | 43% |
| Oscar - All Plans | $26 - $353 | 43% |
| Preferred Hlth - All Plans | $32 - $424 | 53% |
| Wppa Providrs Care - All Plans | $33 - $447 | 55% |
| Cigna | $33 - $447 | 55% |
| Multiplan - All Plans | $34 - $457 | 56% |
| Midlands Choice - All Plans | $34 - $457 | 56% |
| Healthy Blue Mcaid - All Plans | $35 - $471 | 58% |
| Blue Cross Blue Shield | $156 - $164 | 259% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (EKG, tracing only) procedure at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $253.00, which matches the facility's median negotiated rate. This cash price is significantly lower than the state average for this service, which is $353.00. While commercial insurance plans like UnitedHealthcare, Humana, and Aetna negotiate rates ranging from $13 to $471 depending on the specific plan, these negotiated amounts often exceed the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $253.00 upfront can be a more cost-effective strategy than relying on insurance, which may result in higher allowed amounts or co-pays that exceed the cash rate.
To ensure you are receiving the most accurate and transparent pricing, it is important to request an itemized bill before finalizing payment, as summary bills often obscure individual charges. If you choose to use insurance, be aware that the facility's negotiated rate of $160.00 is still higher than the Medicare benchmark of $60.27, indicating a markup typical of commercial contracts. Additionally, you should inquire about prompt-pay discounts, which can reduce the final balance by 20% to 50% if paid in full within a short window, effectively bypassing the administrative costs associated with insurance claims processing. Always verify your specific plan's allowed amount and deductible status before scheduling to avoid unexpected balance billing or surprise costs.