EKG tracing at Intermountain Health Spanish Fork Hospital. CPT 93005.
What Intermountain Health Spanish Fork Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$191cash price (self-pay)
$255list price
$5.94–$229range 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 |
| Healthy U | Medicaid | $5.94 |
| Humana | Medicare Choice PPO | $5.94 |
| Molina | Medicare Advantage | $5.94 |
| Molina | Medicare Complete Care HMO SNP | $5.94 |
| Regence BCBS | MedAdvantage PPO | $5.94 |
| SelectHealth | Medicare Advantage | $5.94 |
| UHC | Medicare Advantage | $5.94 |
| Health Plan of Nevada | Medicaid | $32.41 |
| SelectHealth | Medicaid | $32.41 |
| SelectHealth | Signature Individual ACA | $33.68 |
| SelectHealth | Value Individual ACA | $33.68 |
| SelectHealth | Med Individual ACA | $37.10 |
| Intermountain Caregiver Plan | Share Network | $60.82 |
| SelectHealth | SelectShare | $60.82 |
| SelectHealth | SelectValue | $60.82 |
| SelectHealth | FEHBP | $62.12 |
| Donor Connect | Other | $68.85 |
| Intermountain Caregiver Plan | CHP | $69.13 |
| Intermountain Caregiver Plan | Med Network | $69.13 |
| SelectHealth | SelectMed/CHIP | $69.13 |
| SelectHealth | SelectCare | $72.58 |
| Deseret Mutual | Commercial | $147 |
| Deseret Mutual | Connected Utah | $147 |
| Cigna | Open Access Flex | $161 |
| AWH Connected | Connected Utah | $164 |
| EMI Health | Mint | $177 |
Inpatient
$191cash price (self-pay)
$255list price
$16.57–$229range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $16.57 |
| SelectHealth | Med Individual ACA | $75.99 |
| Health Plan of Nevada | Medicaid | $76.50 |
| Intermountain Caregiver Plan | Share Network | $108 |
| SelectHealth | FEHBP | $108 |
| Intermountain Caregiver Plan | CHP | $123 |
| Intermountain Caregiver Plan | Med Network | $123 |
| EMI | Commercial | $138 |
| Deseret Mutual | Commercial | $147 |
| Deseret Mutual | Connected Utah | $147 |
| Regence BCBS | BlueOption | $157 |
| Cigna | Open Access Flex | $161 |
| AWH Connected | Connected Utah | $162 |
| EMI Health | Mint | $177 |
| EMI Health | Network Care | $177 |
| PEHP | Advantage State | $177 |
| BYU Risk Management | Workers Comp | $178 |
| Corporation of the President | Workers Comp | $178 |
| Regence BCBS | High Performance | $178 |
| Regence BCBS | FEHBP | $180 |
| PEHP | Advantage Non-State | $181 |
| BYU Athletics | Commercial | $184 |
| Campbell Scientific | Commercial | $184 |
| CorVel Corporation | Workers Comp | $184 |
| Franklin County | Commercial | $184 |
| Juniper Systems | Commercial | $184 |
| LW Miller | Commercial | $184 |
| Injury Care of Nevada | Workers Comp | $191 |
| Regence BCBS | Traditional | $194 |
| Managed Care Admin | Commercial | $199 |
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 Intermountain Health Spanish Fork Hospital