CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93005
Insurance Median: $201
Cash Discount Price: $257
vs. Medicare Baseline: 3.33x Medicare

The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at UPMC Children's Hospital of Pittsburgh is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 3.33x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$257

Average discount available for prompt cash payment at this facility.

Insurance Median

$201

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: $257 (426%)

Insurance Median: $201 (333%)

Cash: $257 (426% of Medicare)

Ins. Median: $201 (333% 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 333% of the Medicare baseline (a markup of 233%). 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
Aetna	$6 - $235	10%
Upmc Health Plan	$24 - $75	40%
Amerihealth Caritas	$39 - $61	65%
Health Partners Plans (Jefferson Health Plan)	$40	66%
Highmark Wholecare (Prev Gateway)	$42	70%
Pa Health & Wellness	$42	70%
UnitedHealthcare	$42 - $201	70%
Geisinger	$43 - $192	71%
Blue Cross Blue Shield	$47 - $214	78%
Health Plan Of Upper Ohio Valley	$57 - $278	95%
Cigna	$61 - $235	101%
Intergroup	$278 - $364	461%
Coventry/First Health	$342	567%
Saudi Armed Forces	$342	567%
Health Payors Organization	$364	604%
Multiplan	$364	604%
National Provider Network	$385	639%
Private Health Care Systems	$385	639%

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 $257.
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 Children's Hospital of Pittsburgh 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.