EKG tracing at Intermountain Health LDS Hospital. CPT 93005.
What Intermountain Health LDS Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$182cash price (self-pay)
$243list price
$5.94–$219range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $5.94 |
| Aetna | Medicare Adv PPO | $5.94 |
| American Health | Medicare Adv UT HMO I-SNP | $5.94 |
| Health Partners of Nevada | Medicare Advantage | $5.94 |
| Humana | Medicare Choice PPO | $5.94 |
| Molina | Medicare Advantage | $5.94 |
| Molina | Medicare Choice Care HMO | $5.94 |
| Molina | Medicare Complete Care HMO SNP | $5.94 |
| Regence BCBS | MedAdvantage PPO | $5.94 |
| SelectHealth | Medicare Advantage | $5.94 |
| Southwest Behavioral Health | Behavioral Health | $5.94 |
| UHC | Medicare Advantage | $5.94 |
| SelectHealth | Signature Individual ACA | $33.68 |
| SelectHealth | Value Individual ACA | $33.68 |
| SelectHealth | Med Individual ACA | $37.21 |
| Intermountain Caregiver Plan | Share Network | $58.27 |
| SelectHealth | SelectShare | $58.27 |
| SelectHealth | SelectValue | $58.27 |
| SelectHealth | FEHBP | $59.58 |
| Donor Connect | Other | $62.93 |
| Health Plan of Nevada | Medicaid | $65.90 |
| SelectHealth | Medicaid | $65.90 |
| Intermountain Caregiver Plan | Med Network | $66.24 |
| SelectHealth | CHP | $66.24 |
| SelectHealth | Commercial | $66.24 |
| SelectHealth | SelectCare | $69.54 |
| Deseret Mutual | All Other | $140 |
| Deseret Mutual | Select | $141 |
| Cigna | Open Access Flex | $153 |
| AWH Connected | Connected Utah | $157 |
Inpatient
$182cash price (self-pay)
$243list price
$3.16–$219range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $3.16 |
| Health Plan of Nevada | Medicaid | $72.90 |
| Intermountain Caregiver Plan | Share Network | $103 |
| Intermountain Caregiver Plan | Med Network | $117 |
| EMI | Commercial | $131 |
| Deseret Mutual | All Other | $140 |
| Deseret Mutual | Select | $141 |
| Regence BCBS | BlueOption | $150 |
| Cigna | Open Access Flex | $153 |
| AWH Connected | Connected Utah | $154 |
| EMI Health | Mint | $169 |
| EMI Health | Network Care | $169 |
| PEHP | Advantage State | $169 |
| BYU Risk Management | Workers Comp | $170 |
| Corporation of the President | Workers Comp | $170 |
| Regence BCBS | High Performance | $170 |
| Regence BCBS | FEHBP | $171 |
| PEHP | Advantage Non-State | $173 |
| AG Administrators | USU Athletics | $175 |
| BYU Athletics | Commercial | $175 |
| Campbell Scientific | Commercial | $175 |
| CorVel Corporation | Workers Comp | $175 |
| Franklin County | Commercial | $175 |
| Juniper Systems | Commercial | $175 |
| LW Miller | Commercial | $175 |
| Managed Care Admin | Commercial | $175 |
| Injury Care of Nevada | Workers Comp | $182 |
| Regence BCBS | Traditional | $185 |
| Aetna | Connected | $194 |
| Molina | CHIP | $199 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.