Electrocardiogram (EKG, tracing only)
Facility: Greeley County Health Services
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $15
- Cash Discount Price: $235
- vs. Medicare Baseline: 0.25x 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 |
|---|---|---|
| Medicaid / KanCare | $15 | 25% |
| Aetna | $15 | 25% |
| Blue Cross Blue Shield | $213 | 353% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Greeley County Health Services, the cash price of $235.00 is significantly lower than the facility's gross charge of $335.00, offering a potential savings for patients paying out-of-pocket. While the facility's negotiated rate with Aetna is $15.00 and with Medicaid/KanCare is also $15.00, these amounts are notably lower than the cash price, meaning insurance members would pay less than the cash rate. However, if a patient has a high-deductible plan that has not yet met their out-of-pocket maximum, paying the cash price of $235.00 upfront could be more cost-effective than facing a large deductible charge. It is important to note that the median negotiated rate across all payers is $15.00, which is substantially below the cash price, suggesting that for most insured patients, utilizing their insurance coverage will result in a lower financial responsibility.
When evaluating the cost relative to Medicare, the facility's cash price of $235.00 represents a 20% increase over the Medicare benchmark of $60.27 for this procedure. This markup is consistent with commercial pricing structures where negotiated rates often range between 200% and 300% of the Medicare rate, though fair pricing is typically defined as 120% to 150%. Patients should be aware that while the facility is a Critical Access Hospital in Tribune, KS, and is government-owned, the specific pricing for this service does not appear to align with the typical 120% to 150% fair pricing