Electrocardiogram (EKG, tracing only)
Facility: Smith County Memorial Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $90
- Cash Discount Price: $94
- vs. Medicare Baseline: 1.49x 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 |
|---|---|---|
| Medicaid / KanCare | $66 - $94 | 110% |
| Multiplan-All Plans | $85 | 141% |
| Wppa-All Plans | $89 | 148% |
| UnitedHealthcare | $90 | 149% |
| Health Partners Of Ks Ppo-All Plans | $90 | 149% |
| Midlands Choice-All Plans | $90 | 149% |
| Blue Cross Blue Shield | $163 | 270% |
Consumer Guidance & Cost Commentary
For the Electrocardiogram (EKG, tracing only) procedure at Smith County Memorial Hospital in Smith Center, KS, the cash price is $94.00, which matches the facility's cash median. This rate is significantly higher than the state average for this service, which is $60.27, representing a markup of 1.5 times the Medicare benchmark. While the hospital is a Critical Access Hospital with government-local ownership, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rate, which averages $90.00 across the seven payers listed. Because insurance contracts often include administrative overheads that inflate the allowed amount, paying cash upfront can sometimes result in lower out-of-pocket costs, provided the patient secures a prompt-pay discount before the claim is submitted.
To maximize savings, patients should explicitly request a self-pay or prompt-pay discount prior to scheduling their visit, as billing systems may automatically default to insurance processing if a card is on file. It is crucial to avoid balance billing by ensuring the facility submits a claim only after a formal waiver of insurance submission is signed, which protects against unexpected charges for out-of-network ancillary services. If a bill is received, patients should demand a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. By comparing the facility's rates directly to the Medicare benchmark and verifying the specific negotiated amounts for their plan, consumers can make informed decisions about whether to pay cash or utilize insurance coverage.