CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UPMC St Margaret

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $93
Cash Discount Price: $200
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UPMC St Margaret is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.54x the Medicare baseline. Located in 815 Freeport Road, Pittsburgh, PA.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $200 (332%)

Insurance Median: $93 (154%)

Cash: $200 (332% of Medicare)

Ins. Median: $93 (154% 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
UnitedHealthcare	$12	20%
Upmc Health Plan	$12 - $74	20%
Amerihealth Caritas	$16	27%
Highmark Wholecare (Prev Gateway)	$16 - $61	27%
Blue Cross Blue Shield	$17 - $117	28%
Pa Health & Wellness	$18 - $61	30%
Aetna	$59 - $134	98%
Upmc Work Partners	$63	105%
Cigna	$94 - $134	156%
Coventry/First Health	$234	388%
Private Health Care Systems	$267	443%
Selectcare	$267	443%
Humana	$284	471%

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 $200.
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 St Margaret 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.