Electrocardiogram (EKG, tracing only)
Facility: Decatur Health
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $105
- Cash Discount Price: $101
- vs. Medicare Baseline: 1.74x 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.
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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $30 - $105 | 50% |
| UnitedHealthcare | $30 - $134 | 50% |
| Humana | $31 - $108 | 51% |
| Aetna | $45 - $175 | 75% |
| Midlands Choice- All Plans | $45 - $158 | 75% |
| Medicaid / KanCare | $50 - $177 | 83% |
| Blue Cross Blue Shield | $212 | 352% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) service at Decatur Health in Oberlin, KS, the facility's cash median price of $101.00 is notably lower than the state average, which sits at $104.00. While commercial insurance plans like UnitedHealthcare and Aetna have negotiated rates ranging from $30 to $177, these figures 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 directly, as the $101.00 self-pay price is lower than the median negotiated amount of $105.00 and significantly below the gross charge of $113.00. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary widely among the seven payers represented here.
To maximize savings, consumers should proactively request prompt-pay discounts or self-pay rates before check-in, as these can reduce the final bill by 20% to 50% by bypassing costly insurance billing cycles. Additionally, because Medicare sets a benchmark of $60.27 for this procedure, the facility's cash rate represents a markup of approximately 1.7 times the Medicare amount, which aligns with fair pricing standards rather than the inflated chargemaster lists often used for comparison. If you receive a bill after using insurance, always demand a full itemized statement to identify any errors or unbundled codes, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit.