Electrocardiogram (ECG/EKG)
Facility: Cloud County Health Center
Billing Code: 93000 (CPT)
- CPT Billing Code: 93000
- Insurance Median: $71
- Cash Discount Price: $54
- vs. Medicare Baseline: 4.62x 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 462% of the Medicare baseline (a markup of 362%). 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 |
|---|---|---|
| Mpi-All Plans | $20 | 130% |
| Pponext-All Plans | $71 - $76 | 462% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (ECG/EKG) service at Cloud County Health Center in Concordia, KS, the cash price of $54.00 is notably lower than the facility's median negotiated rate of $71.00 and the state of Kansas average of $73.00. While Medicare benchmarks this procedure at $15.36, commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. Because the cash price is significantly below the negotiated amount, patients with high-deductible plans may find it financially advantageous to pay directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not billed at the full insurance rate.
The facility, a voluntary non-profit Critical Access Hospital, reports a gross charge of $77.00, which serves as the starting point for all billing calculations. It is important to note that comparing the cash price to the gross charge can be misleading, as the gross amount includes administrative markups that do not reflect the true cost of care. To maximize savings, consumers should request an itemized bill to review specific CPT codes and avoid summary bills that obscure individual charges. If you receive a balance bill for services rendered at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans balance billing for out-of-network providers at in-network hospitals, so you should dispute any unexpected charges with your insurer rather than paying immediately.