Electrocardiogram (EKG, tracing only)
Facility: Scott County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $216
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.58x 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 358% of the Medicare baseline (a markup of 258%). 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 |
|---|---|---|
| UnitedHealthcare | $21 - $288 | 35% |
| Humana | $101 - $127 | 168% |
| Wppa | $144 - $1,200 | 239% |
| Blue Cross Blue Shield | $164 | 272% |
| Aetna | $216 - $273 | 358% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $101 to $1,200 across five insurance plans, with a median negotiated amount of $216. This figure is significantly higher than the Medicare benchmark of $60.27, which serves as the federal baseline for the true cost of care. While commercial rates often average 200% to 300% of Medicare, the specific negotiated rates here reflect the unique contract dynamics between the hospital and payers like UnitedHealthcare and Humana. Patients should be aware that assuming an in-network rate is the lowest possible price is a common pitfall, as different insurers within the same network may have vastly different allowed amounts for the same procedure.
For patients with high-deductible plans, paying cash directly can sometimes be more cost-effective than relying on insurance, especially if the insurance negotiated rate exceeds the cash price. Although the data does not list a specific cash median, patients are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. Additionally, since the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, patients should verify that all ancillary services, such as lab work, are covered under the same network protections to avoid unexpected secondary charges.