Electrocardiogram (EKG, tracing only)
Facility: St Luke Hospital & Living Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $135
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $135 | 224% |
| Humana | $135 | 224% |
| UnitedHealthcare | $135 | 224% |
| Blue Cross Blue Shield | $135 | 224% |
| Va Ccn | $135 | 224% |
| Bluestem Pace | $135 | 224% |
| Ambetter / Centene | $136 | 226% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) procedure at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $135.00, which aligns exactly with the lowest and highest negotiated amounts reported across all payers for this service. This rate is significantly higher than the Medicare benchmark of $60.27, reflecting the standard administrative markup inherent in commercial insurance contracts. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should note that cash-pay options are not listed in the current data; however, it is always advisable to contact the billing department directly to inquire about self-pay or prompt-pay discounts, as paying upfront can sometimes result in lower out-of-pocket costs compared to insurance reimbursement, particularly for those with high-deductible plans.
The data indicates that the facility's negotiated rate of $135.00 is consistent across all seven payers, including major carriers like Humana and UnitedHealthcare, as well as state and tribal programs. Because this service is a standard CPT code with uniform pricing across all contracts, there is no variation in the allowed amount based on the specific insurance plan. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not apply to cash-pay scenarios. To ensure transparency, consumers should request a full itemized bill before finalizing payment to verify that no unbundled codes or services not rendered have been included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.