CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $231
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 3.83x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Alice Peck Day Memorial Hospital is $231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.83x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$231

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: $163 (270%)
Insurance Median: $231 (383%)
Cash: $163 (270% of Medicare)
Ins. Median: $231 (383% 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 383% of the Medicare baseline (a markup of 283%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Ambetter / Centene $9 15%
Nh Healthy Families $9 15%
Medicaid / KanCare $139 231%
Blue Cross Blue Shield $149 - $269 247%
Harvard Pilgrim $188 - $262 312%
UnitedHealthcare $217 360%
Tufts $221 367%
Cigna $231 - $247 383%
Commercial Generic $231 383%
Connecticut General $231 383%
Klais $233 387%
Wellpoint $237 393%
Aetna $272 451%
Mvp $275 456%
Coventry Health $287 476%
Coventry Health Wc $287 476%
Humana $314 521%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Alice Peck Day Drive, Lebanon, NH 03766
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals