Emergency visit, high (level 4) at BSA Hospital. CPT 99284.
What BSA Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$304cash price (self-pay)
$3,044list price
$285–$2,860range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Star Superior Medicaid [1945] | Superior Chip [194501] | $322 |
| Star Superior Medicaid [1945] | Superior Star Medicaid [194500] | $906 |
| First Care Commercial [1371] | Firstcare HMO [137103] | $944 |
| Umr - Ardent Employee [2036] | Umr - Ardent Employee [203601] | $1,015 |
| Star Superior Medicaid [1945] | Superior Star Plus [1945001] | $1,068 |
| United Healthcare [2060] | United Healthcare Core Exclusive [206022] | $1,303 |
| Umr [2035] | Umr Core [203505] | $1,303 |
| Amerigroup Commercial [5055] | Wellpoint Fka Amerigroup Mcare Sup [505 | $1,431 |
| United Healthcare Centennial Care [2250] | UHC Comm Mcaid Health Pla [ | $1,431 |
| Healthfirst Medicaid [3870] | Healthfirst Medicaid [387000] | $1,431 |
| Nreca [1735] | Nreca [173500] | $1,866 |
| United Behavioral Health [3820] | United Behavioral Medicare Advantage | $1,866 |
| United Healthcare [2060] | United Healthcare Student Svc [206012] | $1,866 |
| Umr [2035] | Umr Choice [203500] | $1,866 |
| Aetna [1015] | Aetna Client Specific [101506] | $1,979 |
| Phcs [1780] | Phcs Multiplan [178000] | $2,131 |
| Phcs [1780] | Freedom Life [178009] | $2,131 |
| Northamerica Administrators [1725] | Northamerica Administrators [1725 | $2,131 |
| Phoenix Home Life [1785] | Phoenix Home Life [178500] | $2,131 |
| Principal Mutual Life [1845] | Principal Colorado Claims [184500] | $2,131 |
| Pan American Life Insurance Co [1770] | Pan American Life [177000] | $2,131 |
| Rh Administrators [1885] | Rh Administrators [188500] | $2,131 |
| Cbsa [1215] | Cbsa [121500] | $2,131 |
| Federated Mutual [1365] | Federated Mutual [136500] | $2,131 |
| Cherokee Insurance [1245] | Cherokee Insurance [124500] | $2,131 |
| Lewer Agency [1565] | Lewer Agency [156500] | $2,131 |
| National Association Of Letter Carriers [1695] | Nalc [169500] | $2,210 |
| Umr [2035] | Umr Options [203501] | $2,213 |
| Reserve National [1880] | Reserve National [188000] | $2,283 |
| Rural Carrier Benefit Plan [1895] | Rural Carrier Benefit Plan [189500 | $2,283 |
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