CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $129
Cash Discount Price: $190
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UMass Memorial Health - Harrington Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.14x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $190 (315%)

Insurance Median: $129 (214%)

Cash: $190 (315% of Medicare)

Ins. Median: $129 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Wellpoint [11112]	$61	101%
Champva [11001]	$71	118%
Cigna	$72 - $148	119%
Institution [10406]	$72	119%
Mgb Mcr [10124]	$72	119%
Tufts Us Family [11203]	$72	119%
Blue Cross Blue Shield	$74 - $101	123%
Aetna	$75 - $190	124%
Commonwealth Care Alliance [10103]	$75	124%
Fallon Mcr Supp [20202]	$75	124%
Fallon Mcr [10105]	$75	124%
Tufts Mcr [10112]	$75	124%
UnitedHealthcare	$75 - $190	124%
Senior Whole Health [10110]	$77	128%
Workers Compensation [20501]	$93	154%
Medicaid / KanCare	$99	164%
Tufts Connectorcare [10507]	$122	202%
Hne [11108]	$124	206%
Tufts [11201]	$135	224%
Fallon Connectorcare [10503]	$136	226%
First Health Network [11120]	$142	236%
Evernorth Behavioral Health [27]	$152	252%
Harvard Pilgrim [10701]	$153 - $183	254%
Connecticare [11105]	$190	315%
Fallon Carelon Hlth [28]	$190	315%
Fallon Mcaid Carelon Hlth [29]	$190	315%
Grants [20507]	$190	315%
Masshealth Mcd Mbhp [38]	$190	315%
Wellsense Mcaid Carelon Hlth [21]	$190	315%
Hsno/Free Care [10801]	$681	1130%

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 $190.
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 Health - Harrington Hospital 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.