Electrocardiogram (EKG, tracing only)
Facility: Morris County Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $178
- Cash Discount Price: $158
- vs. Medicare Baseline: 2.95x 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 295% of the Medicare baseline (a markup of 195%). 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 |
|---|---|---|
| Choice Care Mcr Adv-All Plans | $103 | 171% |
| Va Ccn-All Plans | $103 | 171% |
| Blue Cross Blue Shield | $103 - $164 | 171% |
| UnitedHealthcare | $103 - $264 | 171% |
| Coventry Mcr | $103 | 171% |
| Cigna | $191 | 317% |
| Aetna | $237 | 393% |
| Multiplan-All Plans | $238 | 395% |
| Coventry Comm-All Other Plans | $238 | 395% |
| Providrs Care (Wppa)(Nexus)-All Plans | $396 | 657% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at Morris County Hospital in Council Grove, Kansas, the cash price of $158 is significantly lower than the average negotiated rates paid by insurance companies, which range from $103 to $396 depending on the payer. While the facility's cash rate is higher than its own Medicare benchmark of $60.27, it remains well below the gross chargemaster price of $264. Patients with high-deductible plans or those who have not yet met their out-of-pocket maximums may find paying the cash price directly more cost-effective than relying on insurance, as commercial negotiated rates often include administrative overhead that inflates the final bill. It is important to note that while the facility is a Critical Access Hospital with government local ownership, patients should always verify their specific plan's allowed amount and ask the billing department about any "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the total cost.
The data indicates that the median amount paid by insurers for this service is $103, which is lower than the cash price, suggesting that for some patients with active coverage, insurance may result in a lower out-of-pocket expense despite the higher gross charges. However, this varies widely across payers, with some commercial plans negotiating rates as high as $396, which exceeds the cash price by more than double. To avoid unexpected balance billing, patients should be aware that the No Surprises Act protects them from being billed the difference between the provider's full rate and their insurance allowed amount for emergency care and non-emergency services at in-network facilities. If a patient receives an itemized bill that appears to