Electrocardiogram (EKG, tracing only)
Facility: Clay County Medical Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $99
- Cash Discount Price: $106
- vs. Medicare Baseline: 1.64x 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 |
|---|---|---|
| Aetna | $52 - $145 | 86% |
| Wppa/Providrs Care- All Plans | $52 - $145 | 86% |
| Health Partners - All Plans | $53 - $148 | 88% |
| UnitedHealthcare | $53 - $148 | 88% |
| Multiplan- All Plans | $53 - $148 | 88% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (EKG, tracing only) procedure at Clay County Medical Center in Clay Center, KS, the facility's cash median price is $106.00, which matches the gross chargemaster rate. This cash price is notably higher than the state average for this service, as the median paid across all payers is $53.00. While commercial insurance contracts typically cap charges at negotiated rates—often resulting in payments around $53.00 for this facility—patients with high-deductible plans may find paying the full cash price of $106.00 more cost-effective if their insurer's negotiated rate exceeds the cash amount. It is important to note that the facility is a Critical Access Hospital owned by the local government, and while the facility rating is 3, the pricing structure reflects standard administrative costs associated with billing commercial insurers rather than the lower cash rates available for self-pay.
The Medicare benchmark for this procedure is $60.27, which serves as a reliable baseline for evaluating the facility's pricing markup. The facility's negotiated rate of $99.00 is approximately 1.6 times the Medicare amount, indicating a markup that is higher than the typical 120% to 150% range considered fair. Patients should be aware that balance billing is generally prohibited for in-network services at this facility, but they should still request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final statement. Additionally, since the facility offers prompt-pay discounts to patients who pay upfront, it is advisable to contact the billing department before scheduling to confirm self-pay rates and potential discounts, ensuring you