Electrocardiogram (EKG, tracing only)
Facility: Memorial Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $74
- Cash Discount Price: $63
- vs. Medicare Baseline: 1.23x 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 |
|---|---|---|
| Tricare | $6 - $119 | 10% |
| Ambetter / Centene | $7 - $131 | 12% |
| Medicare (plans) | $32 - $120 | 53% |
| Humana | $32 - $119 | 53% |
| Blue Cross Blue Shield | $41 - $174 | 68% |
| Coventry - All Other Plans | $57 - $215 | 95% |
| Health Partners Of Kansas - All Plans | $60 - $227 | 100% |
| Preferred Healthcare-All Plans | $60 - $227 | 100% |
| Wppa/Providers Care-All Plans | $88 - $334 | 146% |
Consumer Guidance & Cost Commentary
For the CPT code 93005, Electrocardiogram (EKG, tracing only), Memorial Hospital in Abilene, KS, lists a cash price of $63.00, which matches the cash median for this service. While the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates paid by insurance plans range from $6 to $227, with a median negotiated amount of $74.00. This indicates that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $63.00 upfront could result in significant savings compared to the average insurance allowed amount. It is important to note that while the facility offers a cash rate, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling to ensure they qualify for any additional fee reductions, as billing systems may default to insurance processing if a card is on file.
When evaluating the cost of this procedure, it is essential to compare the facility's pricing against the Medicare benchmark, which serves as the most reliable indicator of the true cost of care. The Medicare amount for this service is $60.27, and the facility's cash rate of $63.00 is only slightly above this baseline, suggesting a pricing structure that is relatively fair and close to the federal cost basis. In contrast, the median negotiated rate of $74.00 reflects the administrative overhead and contract dynamics of commercial insurance, which often inflate the baseline price by 20% to 40%. Patients should avoid relying on the hospital's gross charge list for comparisons, as these figures are inflated to make