Electrocardiogram (EKG, tracing only)
Facility: Oakleaf Surgical Hospital
Billing Code: 93005 (CPT)
- CPT Billing Code: 93005
- Insurance Median: $58
- Cash Discount Price: $112
- vs. Medicare Baseline: 0.96x 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 |
|---|---|---|
| Blue Cross Blue Shield | $58 | 96% |
| Dean Health Plan | $58 | 96% |
| Group Health Cooperative Of Eau Claire | $58 | 96% |
| Healthpartners | $58 | 96% |
| Humana | $58 | 96% |
| Medica | $58 | 96% |
| Quartz Health Solutions | $58 | 96% |
| Security Health Plan Of Wi | $58 - $876 | 96% |
| Ucare Wi | $58 | 96% |
| UnitedHealthcare | $58 | 96% |
Consumer Guidance & Cost Commentary
For an Electrocardiogram (EKG, tracing only) at Oakleaf Surgical Hospital in Altoona, WI, the cash median rate is $112. This facility, which is owned by physicians, has a negotiated rate of $58 and a median paid rate of $99. While the cash price is higher than the negotiated rate of $58, patients with high-deductible plans may find it beneficial to pay the $112 cash median directly, as the insurance negotiated rate for many payers is also $58, potentially leaving them responsible for significant out-of-pocket costs if they have not met their deductible. Always confirm with the hospital regarding "self-pay" or "prompt-pay" discounts before scheduling to ensure you are receiving the most favorable rate available.
The Medicare amount for this service is $60.27, which serves as the benchmark for evaluating commercial pricing. Although the facility's cash rate of $112 is higher than the Medicare amount, the negotiated rate of $58 is lower, reflecting the contractual agreements that protect in-network members. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still request an itemized billing audit before paying any final invoice. Over 80% of hospital bills contain errors, such as double-billing or unbundled codes, so requesting a detailed, line-by-line statement is the most effective way to identify charges for services not rendered or to dispute any discrepancies.