EKG tracing at Gundersen Palmer Lutheran Hospital and Clinic. CPT 93005.
What Gundersen Palmer Lutheran Hospital and Clinic publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$138cash price (self-pay)
$232list price
$11.76–$225range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $11.76 |
| Molina Health | Managed Medicaid | $11.76 |
| Wellmark | HMO | $59.81 |
| Wellmark | Indemnity/PPO | $65.68 |
| Quartz | All Products | $98.14 |
| Quartz | All Other Self Funded | $102 |
| Quartz | Self Funded | $109 |
| Quartz | Level Funded | $113 |
| UHC | All Payer Appendix | $115 |
| Health Partners | Medicaid HMO | $116 |
| Wellmark | All Products | $118 |
| Alliance | Comprehensive/All Products | $121 |
| Alliance | Premier/All Products | $121 |
| Aetna | Medicare Advantage | $121 |
| Amerigroup | Medicare Advantage | $121 |
| Health Partners | Medicare Advantage | $121 |
| Humana | Medicare Advantage | $121 |
| Iowa Total Care | Medicaid | $121 |
| Managed Health Service | Managed Medicaid | $121 |
| Quartz | Medicaid_Badgercare | $121 |
| Quartz | Medicare Advantage | $121 |
| UHC | Medicare Advantage | $121 |
| Wellmark | Medicare Advantage | $121 |
| Quartz | Fully Insured | $126 |
| UCARE | MSHO/Minnesota Special Needs | $128 |
| UCARE | Non-Dually Eligible | $128 |
| UCARE | Dually Eligible | $128 |
| Health Partners | Medicare Cost | $139 |
| Medical Associates | CAH Specific | $186 |
| Trilogy | All Products | $186 |
Inpatient
$138cash price (self-pay)
$232list price
$98.14–$225range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $137 |
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All common services at Gundersen Palmer Lutheran Hospital and Clinic