Emergency visit, high (level 4) at Banner University Medical Center South. CPT 99284.
What Banner University Medical Center South publishes for this service, straight from its standard-charges file, last updated March 2, 2026.
Outpatient / ER
$1,044cash price (self-pay)
$2,069list price
$221–$2,214range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Arizona Physicians IPA | Medicaid | $221 |
| Banner University Health Plan | AZ Medicaid - AHCCCS | $221 |
| Banner University Health Plan | University Family Plan | $221 |
| Health Net | Medicaid | $221 |
| Mercy Care | Medicaid | $221 |
| Health Choice Arizona, Inc. | Medicaid | $332 |
| Banner Health | Medicare Advantage | $454 |
| Blue Cross Blue Shield of Arizona | Medicare Advantage | $454 |
| Aetna | Medicare Advantage | $454 |
| Arizona Physicians IPA | Medicare Advantage | $454 |
| Banner University Health Plan | Medicare Advantage | $454 |
| Cigna Healthcare of Arizona, Inc. | HMO Medicare Advantage Plan | $454 |
| Cigna Healthcare of Arizona, Inc. | PPO Medicare Advantage Plan | $454 |
| Gila River Health Care Corporation | Managed Care Program | $454 |
| Health Choice Arizona, Inc. | Medicare Advantage | $454 |
| Health Net | Medicare | $454 |
| Kaiser Foundation Health Plan | Medicare Advantage | $454 |
| Mercy Care | Mercy Care Advantage | $454 |
| Humana | Medicare Advantage | $467 |
| Devoted Health Services | Medicare Advantage | $477 |
| Carelon | Medicare Advantage | $477 |
| Arizona Priority Care | Alignment Health Plans Medicare Advantage/Eter | $499 |
| Gold Kidney Health Plan | Medicare Advantage | $499 |
| NaphCare | Federal | $613 |
| Aetna | Qualified Health Plan | $617 |
| Health Net | Commerical Exchange Product | $672 |
| Health Choice Arizona, Inc. | ACA Health Plan | $681 |
| Oscar Health Plan | Commercial | $749 |
| Aetna | Banner Employee Plans | $876 |
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $931 |
Inpatient
$1,044cash price (self-pay)
$2,069list price
$931–$1,655range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $931 |
| Plotkin Health | Plotkin Health | $931 |
| Aetna | Medical Rental | $1,090 |
| Quiktrip Corporation | Commercial | $1,117 |
| Provider Network of America | Commercial | $1,552 |
| Arizona Medical Network | Commercial | $1,655 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Banner University Medical Center South