CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UPMC Pinnacle Hospitals

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $134
Cash Discount Price: $197
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UPMC Pinnacle Hospitals is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 2.22x the Medicare baseline. Located in 409 South Second Street, Harrisburg, PA.

Cash / Self-Pay

$197

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $197 (327%)

Insurance Median: $134 (222%)

Cash: $197 (327% of Medicare)

Ins. Median: $134 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
Amerihealth Caritas	$13	22%
Health Partners Plans (Jefferson Health Plan)	$14	23%
UnitedHealthcare	$14 - $63	23%
Geisinger	$15	25%
Pa Health & Wellness	$18 - $63	30%
Blue Cross Blue Shield	$48 - $228	80%
Keystone Health Plan	$48 - $240	80%
Prime Net	$59 - $311	98%
Humana	$60	100%
Upmc Health Plan	$60	100%
Aetna	$61 - $253	101%
Cigna	$61	101%
Upmc Work Partners	$73	121%
Intergroup	$157 - $351	260%
Wellspan Population Health	$206 - $351	342%

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 $197.
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 UPMC Pinnacle 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.