Electrocardiogram (EKG, tracing only)
Facility: Phillips County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $98
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.63x 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 |
|---|---|---|
| UnitedHealthcare | $43 - $227 | 71% |
| Blue Cross Blue Shield | $44 - $184 | 73% |
| Health Partners-All Plans | $54 - $227 | 90% |
| Medicaid / KanCare | $54 - $227 | 90% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG) procedure at Phillips County Hospital in Phillipsburg, KS, the negotiated rates paid by major insurers like UnitedHealthcare and Blue Cross Blue Shield range from $43 to $227, while the cash price is $83. This cash rate is notably lower than the facility's negotiated average of $98, meaning patients with high-deductible plans or those without insurance could save money by paying cash directly. However, because the facility is a Critical Access Hospital with government ownership, it is important to verify if your specific insurance plan has a lower allowed amount than the cash price before scheduling, as commercial contracts often include administrative fees that can make the negotiated rate higher than the self-pay option.
To avoid unexpected costs, patients should request a prompt-pay discount before check-in, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. If you do receive a bill after insurance submission, ensure you have an itemized statement to check for errors, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Additionally, while the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, you should still review your statement carefully and dispute any charges that appear incorrect in writing rather than accepting summary bills or verbal assurances.