EKG tracing at Gundersen Moundview Hospital and Clinics. CPT 93005.
What Gundersen Moundview Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$159cash price (self-pay)
$312list price
$11.76–$303range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $11.76 |
| Anthem | Medicaid | $73.93 |
| Group Health Eau Claire | Medicaid HMO | $73.93 |
| Group Health of South Central | Medicaid HMO | $73.93 |
| Iowa Total Care | Medicaid | $73.93 |
| Managed Health Service | Managed Medicaid | $73.93 |
| Quartz | Medicaid_Badgercare | $73.93 |
| Alliance | Premier/All Products | $121 |
| Alliance | Comprehensive/All Products | $121 |
| Quartz | All Products | $132 |
| Quartz | All Other Self Funded | $137 |
| Security Health Plan | Medicare Advantage | $144 |
| Anthem | Medicare HMO/PPO | $144 |
| Health Partners | Medicare Advantage | $144 |
| Quartz | Medicare Advantage | $144 |
| Security Health Plan | Medicare + Choice | $144 |
| UCARE | Dually Eligible | $144 |
| Quartz | Self Funded | $147 |
| UCARE | MSHO/Minnesota Special Needs | $150 |
| UCARE | Non-Dually Eligible | $150 |
| Quartz | Level Funded | $151 |
| Health Partners | Medicaid HMO | $156 |
| Quartz | Fully Insured | $170 |
| Health Partners | Medicare Cost | $187 |
| Anthem | State Specific | $227 |
| Anthem | HMO/POS | $227 |
| Anthem | PPO | $227 |
| Cigna | All Products | $241 |
| Dean Health Plan | ASO | $245 |
| Group Health of South Central | All Products | $250 |
Inpatient
$159cash price (self-pay)
$312list price
$132–$303range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $184 |
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All common services at Gundersen Moundview Hospital and Clinics