Electrocardiogram (EKG, tracing only)
Facility: Sheridan County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $141
- Cash Discount Price: $208
- vs. Medicare Baseline: 2.34x 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 234% of the Medicare baseline (a markup of 134%). 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 |
|---|---|---|
| Celtic Insurance | $48 - $203 | 80% |
| UnitedHealthcare | $76 - $318 | 126% |
| Blue Cross Blue Shield | $80 - $227 | 133% |
Consumer Guidance & Cost Commentary
For this Electrocardiogram (EKG) service at Sheridan County Hospital in Hoxie, KS, the cash price is $208.00, which matches the facility's median negotiated rate of $141.00 when adjusted for the specific payer context provided. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance rates for this procedure can vary significantly. For instance, UnitedHealthcare plans may face negotiated rates as high as $318, whereas Celtic Insurance plans are capped at $203. If you have a high-deductible plan or are self-pay, paying the cash price of $208.00 directly might be more cost-effective than relying on insurance, especially if your insurer's negotiated rate exceeds this amount. Always ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost by bypassing administrative processing fees.
It is important to understand that commercial insurance rates are often higher than the Medicare benchmark of $60.27 for this code, reflecting the administrative costs and contract dynamics of private payers. The data shows a ratio of 2.3 when comparing the cash price to the Medicare amount, indicating that commercial rates include significant markups beyond the federal baseline. Because over 80% of hospital bills contain errors, patients should never accept a summary bill as final; instead, request a full itemized statement to verify that no services were unbundled or double-charged. If you receive a balance bill from an out-of-network provider, even at an in-network facility, you have the right to dispute the charge under the No