CMS Price Transparency Data

Electrocardiogram (EKG, tracing only)

Facility: Mountain West Medical Center

Billing Code: 93005 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93005
  • Insurance Median: $473
  • Cash Discount Price: $369
  • vs. Medicare Baseline: 7.85x Medicare
The contracted insurance negotiated median rate for a Electrocardiogram (EKG, tracing only) at Mountain West Medical Center is $473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $369. Compared to the federal Medicare reimbursement reference rate of $60.27, this hospital’s rate is 7.85x the Medicare baseline. Located in 2055 North Main Street, Tooele, UT.
Cash / Self-Pay
$369

Average discount available for prompt cash payment at this facility.

Insurance Median
$473

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$60.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $60.27 (100%)
Cash / Self-Pay: $369 (612%)
Insurance Median: $473 (785%)
Cash: $369 (612% of Medicare)
Ins. Median: $473 (785% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $60.27 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 785% of the Medicare baseline (a markup of 685%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $56 - $60 93%
Select Health McR Adv $60 100%
Medicare (plans) $75 124%
U of Ut-All Plans $388 - $523 644%
Wise/Motivhealth-All Plans $388 - $523 644%
Cigna $423 - $571 702%
Dmba-All Plans $430 - $580 713%
Aetna $448 - $604 743%
Pehp-All Plans $448 - $604 743%
Select Health-All Other Plans $448 - $604 743%
UnitedHealthcare $460 - $620 763%
Multiplan Primary Network-All Other Plans $472 - $636 783%
Humana $508 - $684 843%
Emi-All Plans $508 - $684 843%
Multiplan Complimentary Network $549 - $741 911%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2055 North Main Street, Tooele, UT 84074
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals