CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Brigham and Women's Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $136
Cash Discount Price: $251
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Brigham and Women's Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.26x the Medicare baseline. Located in 75 Francis Street, Boston, MA.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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: $251 (416%)

Insurance Median: $136 (226%)

Cash: $251 (416% of Medicare)

Ins. Median: $136 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Tricare	$67	111%
Molina [1014]	$69	114%
Tufts Health Plan [170001]	$69	114%
Tufts Health Public Plans [1013]	$69	114%
UnitedHealthcare	$69 - $273	114%
Blue Cross Blue Shield	$71 - $175	118%
Commonwealth Care Alliance [1007]	$71	118%
Elder Services [1037]	$71	118%
Fallon Health [1008]	$71	118%
Generic Commercial [1009]	$71	118%
Humana	$71	118%
Martin'S Point [160007]	$71	118%
Medicare (plans)	$71	118%
Mgb Health Plan [150001]	$71 - $128	118%
Wellsense Nh [1050]	$71	118%
Centers Of Excellence [1026]	$88 - $240	146%
Cigna	$178 - $266	295%
International Commercial [140001]	$217 - $273	360%
Aetna	$233	387%
Health New England [1034]	$257	426%
Phcs Multiplan [1022]	$257	426%

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 $251.
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 Brigham and Women's 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.