EKG tracing at IU Health Jay Hospital. CPT 93005.
What IU Health Jay Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$130cash price (self-pay)
$291list price
$113–$758range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self-Pay | Other - Self-Pay | $130 |
| Caresource | All Government Medicaid HIP | $136 |
| Elevance Health | All Government Medicaid HIP | $136 |
| Managed Health Services | All Government Medicaid HIP | $136 |
| Elevance Health | All Managed Medicaid | $136 |
| Caresource | All Managed Medicaid | $136 |
| Managed Health Services | All Government Medicaid | $136 |
| United Healthcare | All Managed Medicaid | $136 |
| Suburban Health Organization | PPO - Witham Health Services | $153 |
| Suburban Health Organization | PPO - Direct | $153 |
| Elevance Health | All PPO | $165 |
| Elevance Health | All Traditional Plans | $165 |
| Elevance Health | All IUHP Employee Plans | $165 |
| Cigna | HMO - Open Access | $165 |
| Aetna | HMO - Coventry Plans | $165 |
| Cigna | HMO/POS - Arnett Hospital Plans | $165 |
| Aetna | PPO - IN Preferred | $165 |
| Cigna | PPO - New Business | $165 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $165 |
| Encore Health Network | PPO | $165 |
| Aetna | POS - Cox Medical Plans | $165 |
| Aetna | PPO/POS | $165 |
| Cigna | HMO | $165 |
| Cigna | PPO | $165 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $165 |
| SIHO Insurance Services | HMO/POS Plans | $165 |
| Elevance Health | All HMO/POS | $165 |
| SIHO Insurance Services | All PPO Plans | $165 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $165 |
| United Healthcare | All Managed Care | $165 |
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