EKG tracing at Holy Cross Hospital - Jordan Valley West. CPT 93005.
What Holy Cross Hospital - Jordan Valley West publishes for this service, straight from its standard-charges file, last updated February 11, 2026.
Outpatient / ER
$175cash price (self-pay)
$437list price
$4.87–$478range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Colorado Access | Managed Medicaid | $4.87 |
| Denver Health | Managed Medicaid | $4.87 |
| Health Choice | Managed Medicaid | $4.87 |
| Molina | Managed Medicaid | $4.87 |
| UUHP | Managed Medicaid | $4.87 |
| Humana | Managed Medicare | $5.62 |
| Medicare | Managed Medicare | $5.62 |
| Medicare | Medicare | $5.62 |
| Employer Direct Healthcare | Commercial PPO/POS/HMO | $7.05 |
| MotivHealth | Commercial PPO/POS/HMO | $7.45 |
| Molina | Commercial PPO/POS/HMO | $13.05 |
| UUHP | Commercial Health Plus | $59.66 |
| UUHP | Commercial Healthy Preferred | $64.15 |
| UUHP | Commercial Healthy Premier | $71.28 |
| Regence Blue Cross Blue Shield | Commercial Savewell | $74.75 |
| Centura Employee Plan | Commercial PPO/POS/HMO/EPO | $75.00 |
| Regence Blue Cross Blue Shield | Commercial UVU | $92.09 |
| Regence Blue Cross Blue Shield | Commercial PPO | $108 |
| Regence Blue Cross Blue Shield | Commercial PAR | $116 |
| Cigna Healthcare | Commercial Local Plus | $156 |
| PEHP | Commercial Capital Network | $187 |
| Aetna | Commercial Peak Performance | $193 |
| PEHP | Commercial Summit Exclusive | $207 |
| Cigna Healthcare | Commercial HMO/NBP/OAP | $220 |
| PEHP | Commercial Summit | $223 |
| Aetna | Commercial Standard Network | $230 |
| Cigna Healthcare | Commercial All Other | $268 |
| Deseret Mutual Benefit Administrators | Commercial PPO/POS/HMO | $269 |
| Select Health | Commercial PPO/POS/HMO | $289 |
| Multiplan | Commercial Primary | $302 |
Inpatient
$175cash price (self-pay)
$437list price
$163–$437range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Regence Blue Cross Blue Shield | Commercial Savewell | $163 |
| PEHP | Commercial Capital Network | $187 |
| Molina | Commercial PPO/POS/HMO | $188 |
| Aetna | Commercial Peak Performance | $193 |
| Regence Blue Cross Blue Shield | Commercial UVU | $200 |
| PEHP | Commercial Summit Exclusive | $207 |
| PEHP | Commercial Summit | $223 |
| Aetna | Commercial Standard Network | $230 |
| Wise | Commercial PPO | $232 |
| Regence Blue Cross Blue Shield | Commercial PPO | $236 |
| Regence Blue Cross Blue Shield | Commercial PAR | $262 |
| Deseret Mutual Benefit Administrators | Commercial PPO/POS/HMO | $269 |
| Select Health | Commercial PPO/POS/HMO | $289 |
| Multiplan | Commercial Primary | $302 |
| Aetna | Commercial Signature | $318 |
| Aetna | Commercial Extended Network | $328 |
| Aetna | Commercial Indemnity | $350 |
| Aetna Rental Networks | Commercial PPO/POS/HMO | $370 |
| Multiplan | Commercial Complementary | $398 |
| EMI Health | Commercial PPO/POS/HMO | $437 |
| PEHP | Commercial Advantage | $437 |
| United Healthcare | Commercial Behavioral Health | $437 |
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All common services at Holy Cross Hospital - Jordan Valley West