Emergency visit, high (level 4) at Mercy Hospital Northwest Arkansas. CPT 99284.
What Mercy Hospital Northwest Arkansas publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$1,442cash price (self-pay)
$2,219list price
$12.00–$1,886range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid [20240] | Hb Rogr Arkansas Medicaid | $51.00 |
| Arkansas Department Of Health [20036] | Hb Rogr Arkansas Medicaid | $51.00 |
| Summit Community Care [20368] | Hb Rogr Arkansas Medicaid | $51.00 |
| Summit Community Care Contracted [320368] | Hb Rogr Summit | $51.00 |
| Caresource Medicaid [20460] | Hb Rogr Caresource Medicaid | $52.02 |
| Caresource Medicaid Contracted [320460] | Hb Rogr Caresource Medicaid | $52.02 |
| Empower Healthcare Solutions Medicaid Contracted [320118] | Hb Rogr Pa | $64.77 |
| Arkansas Total Care Contracted [320039] | Hb Rogr Passe Ar Total Care | $116 |
| Arkansas Total Care [20039] | Hb Rogr Passe Ar Total Care | $116 |
| Humana Medicaid Contracted [320486] | Hb Rogr Ok Managed Medicaid | $379 |
| Oklahoma Complete Health Medicaid Contracted [320485] | Hb Rogr Ok Man | $379 |
| Aetna Medicaid Contracted [320009] | Hb Rogr Ok Managed Medicaid | $379 |
| Medicaid [20240] | Hb Rogr Oklahoma Medicaid | $379 |
| Medica Medicare Advantage Contracted [320477] | Hb Rogr Managed Medica | $382 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Rog | $382 |
| BCBS Medicare Advantage [20047] | Hb Rogr Managed Medicare | $382 |
| Unicare Medicare [20384] | Hb Rogr Managed Medicare | $382 |
| Devoted Health Medicare Contracted [320500] | Hb Rogr Devoted Health M | $398 |
| St Johns Mercy Rehab LLC [20359] | Hb Rogr South Rehab 110% Mcr | $428 |
| Health Choice Contracted [320166] | Hb Rogr Oklahoma State And Educati | $533 |
| Blue Cross And Blue Shield [20053] | Hb Rogr BCBS Exchange | $650 |
| Yuzu Health Contracted [320521] | Hb Rogr Dec Level Health - New 01.01 | $733 |
| Mercy Benefit Admin Contracted [320251] | Hb Rogr Dec Schaefer Qcg | $733 |
| Mercy Benefit Admin Contracted [320251] | Hb Rogr Dec Bartel | $733 |
| Mercy Benefit Admin Contracted [320251] | Hb Rogr Dec Tall Tree | $733 |
| Aither Health Contracted [320449] | Hb Rogr Dec Woodard | $733 |
| Aither Health Contracted [320449] | Hb Rogr Dec Laclede - New 07.01.25 | $733 |
| Edison Health Solutions Contracted [320502] | Hb Rogr Dec Woodard | $733 |
| Aetna [20008] | Hb Rogr Coventry/Aetna | $768 |
| Aetna Contracted [320008] | Hb Rogr Coventry/Aetna | $768 |
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