CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UPMC Bedford Memorial

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $87
Cash Discount Price: $100
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UPMC Bedford Memorial is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 1.44x the Medicare baseline. Located in 10455 Lincoln Highway, Everett, PA.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $100 (166%)

Insurance Median: $87 (144%)

Cash: $100 (166% of Medicare)

Ins. Median: $87 (144% 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	$11 - $112	18%
Upmc Health Plan	$12 - $73	20%
Aetna	$13 - $112	22%
Geisinger	$15	25%
Amerihealth Caritas	$16 - $61	27%
Health Partners Plans (Jefferson Health Plan)	$16	27%
Highmark Wholecare (Prev Gateway)	$16 - $61	27%
Pa Health & Wellness	$18 - $61	30%
Blue Cross Blue Shield	$46 - $57	76%
Upmc Work Partners	$55	91%
Cigna	$61 - $112	101%
Intergroup	$109 - $150	181%
Coventry/First Health	$117	194%
Preferred Healthcare System	$134	222%
Health Coalition Partners	$150	249%
Humana	$150	249%
Private Health Care Systems	$150	249%
Selectcare	$150	249%

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 $100.
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 Bedford Memorial 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.