Electrocardiogram (EKG, tracing only)
Facility: William Newton Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $96
- Cash Discount Price: $252
- vs. Medicare Baseline: 1.59x 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 |
|---|---|---|
| Triwest- All Plans | $83 - $93 | 138% |
| Ambetter / Centene | $86 - $267 | 143% |
| Blue Cross Blue Shield | $86 - $156 | 143% |
| UnitedHealthcare | $86 - $240 | 143% |
| Providrs Care Nexus | $146 - $163 | 242% |
| Providrs Care - All Other Plans | $167 - $187 | 277% |
Consumer Guidance & Cost Commentary
For this electrocardiogram (EKG) service at William Newton Hospital in Winfield, KS, the cash price is $252.00, which matches the facility's median negotiated rate. While the hospital is a Critical Access Hospital owned by the local government, the cash price is significantly higher than the Medicare benchmark of $60.27, reflecting a markup of 1.6 times the federal rate. It is important to note that commercial insurance negotiated rates for this procedure range from $83 to $267 across six different payers, meaning that for patients with high-deductible plans, paying the full cash price of $252.00 upfront could result in lower out-of-pocket costs than the insurance allowed amount, especially if the patient has not yet met their deductible.
Before scheduling, patients should verify their specific plan's allowed amount, as commercial rates can vary widely even within the same network. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to confirm that all ancillary services, such as lab work, are also covered under the same network protections. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service. Given that over 80% of hospital bills contain errors, patients are encouraged to request a detailed, itemized statement to ensure no charges are unbundled or for services that were never rendered.