Emergency visit, highest (level 5) at BSA Hospital. CPT 99285.
What BSA Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$365cash price (self-pay)
$3,651list price
$342–$5,000range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Medicaid [3845] | Managed Medicaid Other [384500] | $342 |
| BCBS Medicaid [1165] | BCBS TX Medicaid Chip [116506] | $342 |
| BCBS Medicaid [1165] | BCBS Medicaid [116504] | $342 |
| Star Superior Medicaid [1945] | Superior Chip [194501] | $386 |
| Star Superior Medicaid [1945] | Superior Star Medicaid [194500] | $1,087 |
| Maxor Insurance [1610] | Maxor Insurance [161000] | $1,716 |
| Cigna Medicaid Replacement [3945] | Cigna Healthspring Medicaid Replac | $1,716 |
| Scott And White Medicaid Replacement [3730] | Scott And White Health P | $1,716 |
| Aetna Medicaid Replacement [3510] | Aetna Better Health [351001] | $1,716 |
| Fidelis Care Of Nj Medicaid [3770] | Wellcare Medicaid [377500] | $1,716 |
| Texas Childrens Health Plan [3995] | Texas Childrens Health Plan [3995 | $1,716 |
| Umr [2035] | Umr Oon Potter Co [203506] | $1,716 |
| Midland Pace Mcaid [3715] | Midland Pace Mcaid [371500] | $1,716 |
| Group Pension Admin [1450] | Gpa Imagine Health [145009] | $1,826 |
| Texas Rehab [1965] | Ssa [196500] | $2,081 |
| Texas Rehabilitation [1970] | Texas Workforce Commission [197000] | $2,081 |
| Nreca [1735] | Nreca [173500] | $2,238 |
| Pan American Life Insurance Co [1770] | Pan American Life [177000] | $2,556 |
| Northamerica Administrators [1725] | Northamerica Administrators [1725 | $2,556 |
| Phoenix Home Life [1785] | Phoenix Home Life [178500] | $2,556 |
| Phcs [1780] | Freedom Life [178009] | $2,556 |
| Phcs [1780] | Phcs Multiplan [178000] | $2,556 |
| Principal Mutual Life [1845] | Principal Colorado Claims [184500] | $2,556 |
| Rh Administrators [1885] | Rh Administrators [188500] | $2,556 |
| Beech Street [1170] | Beech Street/Cappcare Misc [117000] | $2,556 |
| Comcar Industries [1280] | Comcar Industries [128000] | $2,556 |
| Celtic Life [1220] | Celtic Life [122000] | $2,556 |
| National Association Of Letter Carriers [1695] | Nalc [169500] | $2,651 |
| Cigna [1260] | Cigna [126008] | $2,651 |
| Coresource [1315] | Coresource [131500] | $2,651 |
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