Electrocardiogram (EKG, tracing only)
Facility: Girard Medical Center
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $86
- Cash Discount Price: $143
- vs. Medicare Baseline: 1.43x 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 |
|---|---|---|
| Medicare (plans) | $80 - $86 | 133% |
| Kansas Superior Select-All Plans | $80 - $86 | 133% |
| Blue Cross Blue Shield | $80 - $164 | 133% |
| Aetna | $80 - $430 | 133% |
| Humana | $80 - $86 | 133% |
| Ambetter / Centene | $80 - $86 | 133% |
| UnitedHealthcare | $80 - $234 | 133% |
| Multiplan-All Plans | $212 - $228 | 352% |
| Uhhis-All Plans | $218 - $234 | 362% |
Consumer Guidance & Cost Commentary
For this Electrocardiogram (EKG) service at Girard Medical Center in Kansas, the cash price of $143.00 is significantly lower than the facility's gross charge of $238.00. While the facility is a Critical Access Hospital with a government ownership structure, patients with high-deductible plans may find the cash rate more affordable than their insurance negotiated rates, which range from $80 to $430 depending on the specific plan. It is important to note that commercial insurance rates often include administrative overhead and contract markups that can exceed the true cost of care, making the direct cash price a valuable benchmark for comparison.
Before scheduling, patients should verify their specific plan's negotiated rate, as some commercial payers may charge more than the cash price even when in-network. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the costly insurance claims process. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may protect you from paying the difference, so it is advisable to request an itemized bill to identify any unbundled codes or services not rendered before agreeing to any payment terms.