Electrocardiogram (EKG, tracing only)
Facility: Minneola District Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $203
- Cash Discount Price: $158
- vs. Medicare Baseline: 3.37x 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 337% of the Medicare baseline (a markup of 237%). 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 |
|---|---|---|
| Va Community Care Program-All Plans | $151 | 251% |
| UnitedHealthcare | $151 - $225 | 251% |
| Humana | $151 | 251% |
| Blue Cross Blue Shield | $164 | 272% |
| Providrs Care Network-All Plans | $191 | 317% |
| Corporate Plan Management-All Plans | $191 | 317% |
| Preferred Health Care (Coventry)-All Other Plans | $202 | 335% |
| Triwest-All Plans | $202 | 335% |
| Aetna | $214 - $225 | 355% |
| Health Partners Of Kansas-All Plans | $214 | 355% |
| Phc (Coventry) Leased Network | $214 | 355% |
| Medicaid / KanCare | $225 | 373% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) procedure at Minneola District Hospital, the facility's cash price of $158 is lower than the median negotiated rate of $203 paid by most insurance plans, including UnitedHealthcare and Aetna. While the hospital is a Critical Access Hospital in Kansas, the data does not provide specific county or state average figures for this procedure to compare against. However, the facility's cash rate is notably lower than the Medicare benchmark of $60.27 when adjusted for the facility's specific cost structure, though the raw cash price exceeds the base Medicare amount. Patients with high-deductible plans may find paying the cash price upfront more beneficial than relying on insurance, as the negotiated rates often exceed the cash amount, potentially leaving them with higher out-of-pocket costs after deductibles are met.
To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the bill by 20% to 50% for upfront payment. It is crucial to avoid automatic claims submission, which can void cash agreements and result in higher insurance-deducted bills; signing a waiver of insurance submission at registration is a key step to secure the lower cash rate. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should always review their itemized bills to ensure no unbundled codes or services not rendered are included, as summary bills often obscure these errors.