CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $92
Cash Discount Price: $176
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UMass Memorial Healthalliance Hospitals is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.53x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$176

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $176 (292%)

Insurance Median: $92 (153%)

Cash: $176 (292% of Medicare)

Ins. Median: $92 (153% 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.

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
Workers Compensation [20501]	$58	96%
UnitedHealthcare	$60 - $176	100%
Wellpoint [11112]	$61	101%
Champva [11001]	$63	105%
Cigna	$72 - $140	119%
Correctional Care [11003]	$72	119%
Institution [10406]	$72 - $93	119%
Medicaid / KanCare	$72 - $92	119%
Medicare (plans)	$72	119%
Tufts Dual [10111]	$72	119%
Tufts Us Family [11203]	$72	119%
Blue Cross Blue Shield	$74 - $103	123%
Aetna	$75 - $115	124%
Commonwealth Care Mcr [10115]	$75	124%
Fallon Mcr Supp [20202]	$75	124%
Harvard Pilgrim Mcr [10106]	$75	124%
Mgb Mcr [10124]	$75	124%
Tufts Mcr [10112]	$75	124%
Senior Whole Health [10110]	$77	128%
Hne [11108]	$98	163%
Harvard Pilgrim [10701]	$116 - $140	192%
Tufts Connectorcare [10507]	$122	202%
Tufts [11201]	$128	212%
First Health Network [11120]	$132	219%
Multiplan [11109]	$132	219%
Fallon Connectorcare [10503]	$136	226%
Connecticare [11105]	$176	292%
Fallon Carelon Hlth [28]	$176	292%
Fallon Mcaid Carelon Hlth [29]	$176	292%
Grants [20507]	$176	292%
Hsno/Free Care [10801]	$294	488%

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 $176.
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 UMass Memorial Healthalliance Hospitals 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.