Electrocardiogram (EKG, tracing only)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $155
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.57x 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 257% of the Medicare baseline (a markup of 157%). 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 | $112 - $125 | 186% |
| Blue Cross Blue Shield | $155 - $163 | 257% |
| Providers Care (Wppa)-All Plans | $219 | 363% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at the Hospital District #6 Patterson Health Center in Anthony, KS, the cash price is $100.00, which is lower than the facility's negotiated rates of $155.00 and the highest commercial payer rates of $219.00. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected ancillary services or out-of-network providers could still trigger additional charges if not carefully reviewed. Patients should always ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible rate.
The Medicare benchmark for this procedure is $60.27, which serves as a cost baseline to evaluate pricing markups. Although the data does not provide specific state or county average comparisons for this code, the facility's cash rate of $100.00 represents a reasonable price point relative to the Medicare amount, avoiding the inflated chargemaster lists that often confuse consumers. If you receive a bill, it is crucial to request a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing these errors in writing can significantly reduce medical debt, and patients should verify their deductible status before assuming that an in-network rate is the best price available.