CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Mercy Hospital Joplin

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $172
Cash Discount Price: $260
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Mercy Hospital Joplin is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.85x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$260

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$60.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $60.27 (100%)

Cash / Self-Pay: $260 (431%)

Insurance Median: $172 (285%)

Cash: $260 (431% of Medicare)

Ins. Median: $172 (285% of 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 285% of the Medicare baseline (a markup of 185%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$5 - $248	8%
Blue Cross Blue Shield	$5 - $292	8%
Humana	$5 - $120	8%
Indian Health Service Contracted [320198]	$5 - $260	8%
Medicaid / KanCare	$5 - $112	8%
Champva [20065]	$53	88%
Cherokee Nation Health Serv Contracted [320066]	$53	88%
Cigna	$53 - $308	88%
Cross Timbers Hospice [20098]	$53	88%
Dept Of Veteran Affairs Contracted [320106]	$53	88%
Elara Caring Aspire Hospice [20433]	$53	88%
Globalhealth Contracted [320145]	$53	88%
Halo Hcr Inc Hospice Contracted [320432]	$53	88%
Halo Hcr Inc Hospice [20432]	$53	88%
Kindful Hospice Contracted [320434]	$53	88%
Kindful Hospice [20434]	$53	88%
Medicare (plans)	$53 - $56	88%
Mercy Hospice Okc [20252]	$53	88%
Mercy Mgd Behavioral Health Contracted [320259]	$53	88%
Pace Of The Ozarks Contracted [320518]	$53	88%
Provider Partners Health Plans Contracted [320450]	$53	88%
Qual Choice Contracted [320325]	$53	88%
Tricare	$53	88%
UnitedHealthcare	$53 - $164	88%
Centivo Contracted [320505]	$54	90%
Healthscope Contracted [320182]	$67	111%
United Medical Resources Contracted [320454]	$67 - $164	111%
Health Choice Contracted [320166]	$101	168%
Providrs Care Network Contracted [320484]	$110	183%
Ambetter / Centene	$112	186%
Home State Health Plan Contracted [320187]	$112	186%
Novasys Contracted [320285]	$112	186%
Point C Contracted [320238]	$140 - $320	232%
Medica Contracted [320239]	$146	242%
Benefit Management Contracted [320052]	$172	285%
Health Systems Inc Contracted [320174]	$172	285%
Insurance System Inc Contracted [320465]	$172	285%
Administrative Payor Contracted [320005]	$180	299%
Mercy Benefit Admin Contracted [320251]	$200 - $240	332%
Aither Health Contracted [320449]	$228	378%
Auxiant Contracted [320462]	$228 - $260	378%
Ebms Contracted [320493]	$228	378%
Edison Health Solutions Contracted [320502]	$228	378%
Healthlink Contracted [320179]	$228 - $320	378%
Imagine 360 Contracted [320494]	$228	378%
Reflect Health Contracted [320492]	$228	378%
Yuzu Health Contracted [320521]	$228	378%
90 Degree Benefits Contracted [320436]	$240	398%
Show-Me Health Administrators Contracted [320483]	$240	398%
Preferred Health Plan Contracted [320522]	$260	431%
First Health Contracted [320128]	$272	451%
American Healthcare Alliance Contracted [320020]	$280	465%
Multiplan Contracted [320270]	$308	511%
Private Health Care Systems Contracted [320320]	$308	511%
Usable Contracted [320409]	$308	511%
Point C [20238]	$320	531%
Workers Comp [20426]	$320 - $400	531%
Usa Managed Care Org Contracted [320429]	$352	584%
Ppo Plus Contracted [320310]	$360	597%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $260.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93005.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Joplin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93005.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.