Emergency visit, moderate (level 3) at Mercy Orthopedic Hospital Fort Smith. CPT 99283.
What Mercy Orthopedic Hospital Fort Smith publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$965cash price (self-pay)
$1,484list price
$12.00–$1,300range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Summit Community Care Contracted [320368] | Hb Ftsm Summit | $51.00 |
| Summit Community Care [20368] | Hb Ftsm Ark Medicaid | $51.00 |
| Arkansas Department Of Health [20036] | Hb Ftsm Ark Medicaid | $51.00 |
| Medicaid [20240] | Hb Ftsm Ark Medicaid | $51.00 |
| Caresource Medicaid Contracted [320460] | Hb Ftsm Caresource Medicaid | $52.02 |
| Caresource Medicaid [20460] | Hb Ftsm Caresource Medicaid | $52.02 |
| Empower Healthcare Solutions Medicaid [20118] | Hb Ftsm Passe Empower | $64.77 |
| Empower Healthcare Solutions Medicaid Contracted [320118] | Hb Ftsm Pa | $64.77 |
| Arkansas Total Care [20039] | Hb Ftsm Passe Ar Total Care | $116 |
| Arkansas Total Care Contracted [320039] | Hb Ftsm Passe Ar Total Care | $116 |
| Home State Medicaid Contracted [320189] | Hb Ftsm Managed Mo Mcd | $236 |
| Oklahoma Complete Health Medicaid Contracted [320485] | Hb Ftsm Ok Man | $247 |
| Humana Medicaid Contracted [320486] | Hb Ftsm Ok Managed Medicaid | $247 |
| Medicaid [20240] | Hb Ftsm Ok Medicaid | $247 |
| Aetna Medicaid Contracted [320009] | Hb Ftsm Ok Managed Medicaid | $247 |
| Halo Hcr Inc Hospice Contracted [320432] | Hb Ftsm Managed Medicare | $259 |
| Kindful Hospice Contracted [320434] | Hb Ftsm Managed Medicare | $259 |
| Elara Caring Aspire Hospice Contracted [320433] | Hb Ftsm Managed Medi | $259 |
| United Behavioral Health Medicare Advantage Contracted [320392] | Hb F | $259 |
| United Healthcare Contracted [320396] | Hb Ftsm Managed Medicare | $259 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Ftsm UHC | $259 |
| Tricare Contracted [320380] | Hb Ftsm Tricare | $259 |
| Qual Choice Contracted [320325] | Hb Ftsm Managed Medicare | $259 |
| Nhc Advantage Medicare Contracted [320282] | Hb Ftsm Managed Medicare | $259 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Fts | $259 |
| Wellcare Medicare Advantage Contracted [320421] | Hb Ftsm Novasys Mcr | $267 |
| Devoted Health Medicare Contracted [320500] | Hb Ftsm Devoted Health M | $270 |
| St Johns Mercy Rehab LLC Contracted [320359] | Hb Ftsm Lifepoint Mcr | $291 |
| Health Choice Contracted [320166] | Hb Ftsm Oklahoma State And Educati | $349 |
| Sunflower Health Plan Contracted [320369] | Hb Ftsm Novasys Ambetter E | $370 |
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