Electrocardiogram (EKG, tracing only)
Facility: Fredonia Regional Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $170
- Cash Discount Price: $239
- vs. Medicare Baseline: 2.82x 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 282% of the Medicare baseline (a markup of 182%). 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 | $118 - $164 | 196% |
| Aetna | $122 - $215 | 202% |
| UnitedHealthcare | $122 - $215 | 202% |
| Veterans Programs - All Plans | $122 | 202% |
| Cigna | $215 | 357% |
| Reserve National-All Plans | $215 | 357% |
| Meritain-All Plans | $215 | 357% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Fredonia Regional Hospital in Kansas, the cash price is $239.00, which matches the facility's median negotiated rate. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $122 to $215, these amounts are generally higher than the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that the facility is a Critical Access Hospital with government local ownership, and while the data does not provide a specific county or state average for comparison, the cash rate of $239.00 is identical to the cash median reported for this service. Patients should always ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes reduce the final bill further than the listed cash rate.
The Medicare benchmark for this procedure is $60.27, which serves as a baseline to evaluate the facility's pricing markup. The facility's cash rate of $239.00 represents a significant markup compared to the Medicare amount, which is typical for commercial services that include administrative overhead and profit margins. If you have insurance, your allowed amount will likely fall between the low and high negotiated ranges provided by your specific plan, but be aware that balance billing could occur if you are treated by an out-of-network provider, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure you are not overcharged, request a detailed itemized bill that breaks down every CPT code and charge, as summary bills often hide