Electrocardiogram (EKG, tracing only)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $130
- Cash Discount Price: $146
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Humana | $38 - $130 | 63% |
| Tricare | $42 - $140 | 70% |
| UnitedHealthcare | $49 - $265 | 81% |
| Va Ccn - All Plans | $49 - $164 | 81% |
| Aetna | $49 - $238 | 81% |
| Medicaid / KanCare | $49 - $265 | 81% |
| Ambetter / Centene | $54 - $181 | 90% |
| Health Partners - All Plans | $75 - $252 | 124% |
| Healthy Blue Mcaid - All Plans | $78 - $265 | 129% |
| Blue Cross Blue Shield | $225 | 373% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) procedure at Trego County Lemke Memorial Hospital, the cash price of $146.00 is notably higher than the facility's negotiated rate of $130.00, which serves as the benchmark for in-network insurance payments. While commercial payers like Humana and Tricare negotiate rates ranging from $38 to $140, the facility's cash price remains competitive relative to the broader market, though it is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients with high-deductible plans may find paying the cash price of $146.00 more cost-effective than relying on insurance, as the insurer's allowed amount could be significantly lower than the cash rate, potentially leaving the patient responsible for a larger out-of-pocket balance after deductibles are met.
To ensure you receive the most accurate pricing, it is recommended to explicitly request a "self-pay" or "prompt-pay" discount from the hospital before scheduling your visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you are billed for services rendered by out-of-network providers, such as certain lab services or emergency physicians, the No Surprises Act protects you from balance billing for these specific scenarios, meaning you should not pay the difference between the provider's chargemaster rate and your insurance's allowed amount. Furthermore, if you receive a summary bill, you should demand a full itemized statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute sent to the