Electrocardiogram (EKG, tracing only)
Facility: Children'S Mercy South
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $473
- Cash Discount Price: $348
- vs. Medicare Baseline: 7.85x 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 785% of the Medicare baseline (a markup of 685%). 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 |
|---|---|---|
| UnitedHealthcare | $22 - $488 | 37% |
| Healthy Blue | $23 - $152 | 38% |
| Medicaid / KanCare | $24 | 40% |
| Home State Health | $133 | 221% |
| Blue Cross Blue Shield | $298 - $537 | 494% |
| Cigna | $348 - $505 | 577% |
| Medica | $423 | 702% |
| Aetna | $436 - $494 | 723% |
| Orscheln | $472 | 783% |
| Wppa Providrs Care | $472 | 783% |
| Centivo | $472 | 783% |
| Wellfit/Centrus | $472 | 783% |
| Nebraska Furniture Mart | $472 | 783% |
| Health Midwest Comprehensive Care | $473 | 785% |
| Quiktrip | $473 | 785% |
| Humana | $483 | 801% |
| Coxhealth Network | $537 | 891% |
| Coventry Health Care Of Kansas | $537 | 891% |
| Mercy Health | $544 | 903% |
| Multiplan | $552 | 916% |
| American Healthcare Alliance | $617 | 1024% |
| Healthlink | $639 | 1060% |
| National Preferred Provider Network | $653 | 1083% |
Consumer Guidance & Cost Commentary
For the electrocardiogram (EKG, tracing only) service at Children's Mercy South in Overland Park, KS, the cash median price is $348.00, which is significantly lower than the facility's negotiated rates. While the facility's negotiated average is $473.00, commercial payers like UnitedHealthcare and Healthy Blue have negotiated rates ranging from $22 to $152, indicating substantial variation based on plan type. Patients with high-deductible plans may find paying the cash price of $348.00 more cost-effective than relying on insurance, as the negotiated rates for many commercial carriers exceed this amount. It is important to note that the cash price is also lower than the Medicare benchmark of $60.27 when adjusted for the facility's specific cost structure, though the gross charge of $726.00 serves as the inflated starting point for all billing calculations.
To ensure you receive the most accurate pricing, always request an itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you choose to use insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, but you should still verify your deductible status to avoid unexpected out-of-pocket costs. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total amount owed if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing.