EKG tracing at Saint Alphonsus Medical Center-Ontario. CPT 93005.
What Saint Alphonsus Medical Center-Ontario publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$24.00cash price (self-pay)
$383list price
$4.00–$372range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Id | Medicaid | $34.55 |
| Medicaid - IL | Medicaid | $66.20 |
| Blue Cross - Id Medicare Advantage | Bc Id Medicare Advantage | $68.82 |
| Medicaid - Ne | Medicaid | $70.77 |
| Lakeland Care Inc | Medicaid | $115 |
| Icare Medicaid | Medicaid | $115 |
| Mclaren Health Medicaid | Medicaid | $115 |
| Magellan Behavioral Health Medicaid | Medicaid | $115 |
| Blue Cross Complete - Mi | Medicaid | $115 |
| Medicaid - Ri | Medicaid | $115 |
| Medicaid - Sd | Medicaid | $115 |
| Pacificsource Health Plans | Pacificsource Smart Alliance | $123 |
| Humana | Humana | $176 |
| Cigna | Cigna | $185 |
| Pacificsource Health Plans | Pacificsource | $186 |
| Geha | United Healthcare | $192 |
| United Healthcare | United Healthcare | $192 |
| Blue Cross - Wi (Anthem) | Regence Bs | $229 |
| Blue Cross - IL | Regence Bs | $229 |
| Blue Cross - Ia (Wellmark) | Regence Bs | $229 |
| Blue Cross - Md (Carefirst) | Regence Bs | $229 |
| Blue Cross - Nv (Anthem) | Regence Bs | $229 |
| Blue Cross - Mt | Regence Bs | $229 |
| Blue Cross - Ms | Regence Bs | $229 |
| Blue Cross - Nm | Regence Bs | $229 |
| Blue Care Network | Regence Bs | $229 |
| Blue Cross - Nj (Horizon) | Regence Bs | $229 |
| Blue Cross - Nh (Anthem) | Regence Bs | $229 |
| Blue Cross - NY (Excellus) | Regence Bs | $229 |
| Blue Cross - NY (Anthem) | Regence Bs | $229 |
Inpatient
$18.00cash price (self-pay)
$18.00list price
$4.47–$18.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Mi | Medicaid | $4.47 |
| Medicaid - Id | Medicaid | $4.70 |
| Medicaid - Or | Medicaid | $5.04 |
| Oregon Screenwise | Oregon Screenwise | $5.04 |
| United Healthcare Medicare | UHC Medicare Advantage | $6.61 |
| Selecthealth | Select Health | $10.06 |
| Moda Health | Moda Health Select | $10.06 |
| Mountain Health Co-Op | Mountain Health Co-Op | $10.06 |
| Cigna | Cigna | $10.17 |
| Asuris Northwest Health | Regence Bs Id PPO\Ppp | $10.44 |
| Blue Shield - Id (Regence) | Regence Bs Id PPO\Ppp | $10.44 |
| Healthcare Management Admin | Regence Bs Id PPO\Ppp | $10.44 |
| Pacificsource Health Plans | Pacificsource | $12.15 |
| Selecthealth | Select Health Med Network | $14.63 |
| Geha | United Healthcare | $16.32 |
| United Healthcare | United Healthcare | $16.32 |
| Pacificsource Health Plans | Pacificsource Smart Alliance | $16.96 |
| Medicaid - IL | Medicaid | $17.49 |
| Medicaid - Ne | Medicaid | $18.00 |
| Moda Health | Moda | $18.00 |
| Humana | Humana | $18.00 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Saint Alphonsus Medical Center-Ontario