EKG tracing at Gundersen TriCounty Hospital and Clinics. CPT 93005.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$137cash price (self-pay)
$216list price
$11.76–$205range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $11.76 |
| Anthem | Medicaid | $57.81 |
| Group Health Eau Claire | Medicaid HMO | $57.81 |
| Group Health of South Central | Medicaid HMO | $57.81 |
| Iowa Total Care | Medicaid | $57.81 |
| Managed Health Service | Managed Medicaid | $57.81 |
| Quartz | Medicaid_Badgercare | $57.81 |
| Quartz | All Products | $91.37 |
| Quartz | All Other Self Funded | $95.04 |
| Quartz | Self Funded | $102 |
| Quartz | Level Funded | $105 |
| UCARE | Non-Dually Eligible | $112 |
| UCARE | MSHO/Minnesota Special Needs | $112 |
| UCARE | Dually Eligible | $112 |
| Quartz | Fully Insured | $118 |
| Anthem | Medicare HMO/PPO | $127 |
| Humana | Medicare Advantage | $127 |
| Quartz | Medicare Advantage | $127 |
| UHC | Medicare Advantage | $127 |
| Anthem | State Specific | $149 |
| Anthem | PPO | $149 |
| Anthem | HMO/POS | $149 |
| UHC | All Payer Appendix | $156 |
| Cigna | All Products | $167 |
| Alliance | Premier/All Products | $173 |
| Group Health of South Central | All Products | $173 |
| Trilogy | All Products | $173 |
| UCARE | Qualified Health Plan | $173 |
| Aspirus Arise Health | All Products | $179 |
| Allied National | Core Value Programs | $184 |
Inpatient
$137cash price (self-pay)
$216list price
$91.37–$205range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $127 |
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All common services at Gundersen TriCounty Hospital and Clinics