CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Mercy Hospital Carthage

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $157
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Mercy Hospital Carthage is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.60x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $157 (260%)
Insurance Median: $157 (260%)
Cash: $157 (260% of Medicare)
Ins. Median: $157 (260% 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 260% of the Medicare baseline (a markup of 160%). 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.

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 - $214 8%
Humana $5 - $72 8%
Medicaid / KanCare $5 - $132 8%
Blue Cross Blue Shield $21 - $178 35%
Medicare (plans) $56 - $71 93%
Cherokee Nation Health Serv Contracted [320066] $66 110%
Cigna $66 - $217 110%
Cross Timbers Hospice [20098] $66 110%
Dept Of Veteran Affairs Contracted [320106] $66 110%
Elara Caring Aspire Hospice [20433] $66 110%
Globalhealth Contracted [320145] $66 110%
Halo Hcr Inc Hospice Contracted [320432] $66 110%
Halo Hcr Inc Hospice [20432] $66 110%
Indian Health Service Contracted [320198] $66 110%
Kindful Hospice Contracted [320434] $66 110%
Kindful Hospice [20434] $66 110%
Medical Associates Health Contracted [320444] $66 110%
Mercy Hospice Okc [20252] $66 110%
Mercy Mgd Behavioral Health Contracted [320259] $66 110%
Pace Of The Ozarks Contracted [320518] $66 110%
Provider Partners Health Plans Contracted [320450] $66 110%
Qual Choice Contracted [320325] $66 110%
Tricare $66 110%
UnitedHealthcare $66 - $210 110%
Point C Contracted [320238] $84 - $217 139%
Health Systems Inc Contracted [320174] $104 173%
Insurance System Inc Contracted [320465] $104 173%
Administrative Payor Contracted [320005] $108 179%
Centivo Contracted [320505] $111 184%
Healthscope Contracted [320182] $126 209%
Ambetter / Centene $132 219%
Home State Health Plan Contracted [320187] $132 219%
Novasys Contracted [320285] $132 219%
Benefit Management Contracted [320052] $145 - $210 241%
Auxiant Contracted [320462] $157 - $205 260%
Healthlink Contracted [320179] $157 - $224 260%
Preferred Health Plan Contracted [320522] $157 260%
Workers Comp [20426] $193 - $241 320%
United Medical Resources Contracted [320454] $200 - $217 332%
90 Degree Benefits Contracted [320436] $205 340%
Aither Health Contracted [320449] $205 340%
Ebms Contracted [320493] $205 340%
Edison Health Solutions Contracted [320502] $205 340%
Imagine 360 Contracted [320494] $205 340%
Mercy Benefit Admin Contracted [320251] $205 - $217 340%
Reflect Health Contracted [320492] $205 340%
Show-Me Health Administrators Contracted [320483] $205 340%
Yuzu Health Contracted [320521] $205 340%
Medica Contracted [320239] $209 347%
Evolutions Health Care Contracted [320124] $210 348%
First Health Contracted [320128] $210 348%
Multiplan Contracted [320270] $210 348%
Private Health Care Systems Contracted [320320] $210 348%
American Healthcare Alliance Contracted [320020] $217 360%
Ppo Plus Contracted [320310] $217 360%
Usa Managed Care Org Contracted [320429] $217 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3125 Dr Russell Smith Way, Carthage, MO 64836
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals