CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Southcoast Hospitals Group

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $74
Cash Discount Price: $86
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Southcoast Hospitals Group is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.23x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $86 (143%)

Insurance Median: $74 (123%)

Cash: $86 (143% of Medicare)

Ins. Median: $74 (123% 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
Wellsense Health Plan [1010202]	$25	41%
Tufts Health Public Plans [1010213]	$29 - $412	48%
Wellsense Health Plan Clarity Connectorcare & Meta	$37	61%
Medicare (plans)	$42 - $85	70%
Blue Cross Blue Shield	$65 - $84	108%
Aetna	$71 - $130	118%
Evercare [1010304]	$71	118%
Tufts Senior Care Options [1010315]	$71	118%
Tufts [1010701]	$71	118%
UnitedHealthcare	$71 - $122	118%
Wellsense Health Plan Senior Care Options [1020208	$71	118%
Commonwealth Care Alliance [1080501]	$73	121%
Wellpoint [1000102]	$73	121%
Eternal Health [1010322]	$78	129%
Mass General Brigham Health Plan Commercial [10122	$96	159%
Mass General Brigham Health Plan Connectorcare [10	$96	159%
Fallon [1000114]	$99	164%
Group Insurance Service Center [1013001]	$103	171%
Innovative Health Plan [1025001]	$103	171%
Priority Health [1015001]	$103	171%
Harvard Pilgrim [1010602]	$106	176%
PHCS [1000125]	$111	184%
Cigna	$113	187%
First Health [1000130]	$130	216%

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 $86.
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 Southcoast Hospitals Group 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.