Electrocardiogram (EKG, tracing only)
Facility: Hodgeman County Health Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $174
- Cash Discount Price: $198
- vs. Medicare Baseline: 2.89x 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 289% of the Medicare baseline (a markup of 189%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $156 - $164 | 259% |
| Medicaid / KanCare | $158 - $247 | 262% |
| Humana | $158 | 262% |
| UnitedHealthcare | $158 - $235 | 262% |
| Triwest - All Plans | $158 | 262% |
| Aetna | $198 | 329% |
| First Health - All Plans | $222 | 368% |
| Wppa (Provdrscare) - All Plans | $235 | 390% |
| Health Partners - All Plans | $235 | 390% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price of $198.00 is notably lower than the negotiated rates charged to most insurance payers, which range from $156 to $247. While the facility is a Critical Access Hospital owned by the local government, the data indicates that commercial insurance contracts often result in higher out-of-pocket costs for patients compared to paying cash directly. Specifically, the cash price of $198.00 is significantly lower than the facility's gross charge of $247.00 and aligns closely with the cash median of $198.00 reported for the region. Patients with high-deductible plans may find it financially advantageous to pay the cash price upfront, as the insurance negotiated rates for many plans exceed this amount, potentially leading to higher total costs if the patient's deductible has not yet been met.
When evaluating the cost relative to federal standards, the Medicare allowed amount for this procedure is $60.27, which serves as the objective baseline for pricing. The facility's cash price of $198.00 represents a markup of 2.9 times the Medicare rate, which falls within the typical range of commercial pricing structures where rates often average 200% to 300% of Medicare. To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. It is also important to verify the specific allowed amount for your insurance plan