EKG tracing at Good Samaritan Hospital (GSH). CPT 93005.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$197cash price (self-pay)
$328list price
$5.53–$328range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $5.53 |
| Caresource HIP | Medicaid | $5.53 |
| Caresource | Medicaid | $5.53 |
| Encore Prime | Commercial | $6.89 |
| Aetna | Commercial | $14.86 |
| Aetna | Medicare Advantage | $34.38 |
| Allwell | MCR ADV/PPO/HMO | $34.38 |
| Anthem MCR | MCR ADV/PPO/HMO | $34.38 |
| Anthem MCR | Medicare Advantage | $34.38 |
| Anthem | MCR ADV/PPO/HMO | $34.38 |
| Cigna | Medicare Advantage | $34.38 |
| Humana | Medicare Advantage | $34.38 |
| United Healthcare | Medicare Advantage | $34.38 |
| Alliance Coal | Commercial | $49.98 |
| CareSource | Commercial | $50.78 |
| Indiana University | MCR ADV/PPO/HMO | $62.41 |
| MHS Ambetter | Commercial | $62.41 |
| Meridian | Medicare Advantage | $62.41 |
| Molina | Medicaid | $62.41 |
| Molina | Medicare Advantage | $62.41 |
| Optum | MCR ADV/PPO/HMO | $62.41 |
| Hope Trust | Commercial | $68.77 |
| Anthem | Trad/PPO/HMO | $125 |
| Direct Health | Direct Health | $129 |
| OneCare | Commercial | $130 |
| HealthLink | HMO | $158 |
| Amish | Commercial | $164 |
| HealthLink | PPO | $167 |
| Anthem | Exchange | $187 |
| United Healthcare | Commercial | $215 |
Inpatient
$197cash price (self-pay)
$328list price
$191–$328range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $191 |
| United Healthcare | Commercial | $217 |
| Anthem | Trad/PPO/HMO | $239 |
| Direct Health | Direct Health | $252 |
| SIHO | Commercial | $252 |
| Cigna | Commercial | $259 |
| Sagamore | Commercial | $259 |
| Corvel | Workers Comp | $269 |
| Aetna | Commercial | $275 |
| Anthem | HealthSync | $282 |
| HealthLink | HMO | $289 |
| Encore Prime | Commercial | $295 |
| Humana | Commercial | $295 |
| HealthLink | PPO | $305 |
| Molina | Medicaid | $328 |
| Underwriters Safety | Commercial | $328 |
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