Emergency visit, moderate (level 3) at Dominican Hospital. CPT 99283.

What Dominican Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$1,442cash price (self-pay)

$3,204list price

$63.97–$14,940range insurers pay

Insurance plan	Negotiated rate
BCBS - Anthem \| Medicaid\|All Plans	$63.97
COSC Psych \| Medicaid\|All Plans	$63.97
Central California Alliance for Health \| Medicaid\|All Plans	$63.97
Health Net \| Medicaid\|< 21	$96.78
Health Net \| Medicaid\|> 21	$96.78
Blue Shield CA \| Medicare\|All Plans	$380
Health Net \| Medicare\|All Plans	$380
Kaiser \| Medicare\|All Plans	$380
United \| Medicare\|All Plans	$380
Blue Shield CA \| Commercial\|DHMF	$434
Sutter Health \| Commercial\|All Plans	$1,191
Aetna \| Commercial\|HMO	$1,378
Aetna \| Commercial\|PPO	$1,378
Blue Shield CA \| Commercial\|ACO Trio	$1,890
Cigna \| Commercial\|LocalPlus	$1,922
Blue Shield CA \| Commercial\|Exchange	$1,954
Cigna \| Commercial\|All Other Plans	$2,051
Western Growers \| Commercial\|All Plans	$2,179
Blue Shield CA \| Commercial\|All Other Plans	$2,307
Kaiser \| Commercial\|All Plans	$2,403
Healthsmart \| Commercial\|All Plans	$2,563
First Health \| Commercial\|All Plans	$2,723
Multiplan \| Commercial\|All Plans	$2,723
Health Net \| Commercial\|Community Care	$3,535
Health Net \| Commercial\|Care Product	$4,303
Health Net \| Commercial\|Blue Gold	$4,354
BCBS - Anthem \| Commercial\|All Other Plans	$4,707
Health Net \| Commercial\|All Other Plans	$4,782
BCBS - Anthem \| Commercial\|MCS	$6,576
United \| Commercial\|HMO	$7,166

$1,442cash price (self-pay)

$3,204list price

$1,922–$2,723range insurers pay

Insurance plan	Negotiated rate
Kaiser \| Commercial\|All Plans	$1,922
Healthsmart \| Commercial\|All Plans	$2,563
First Health \| Commercial\|All Plans	$2,723
Multiplan \| Commercial\|All Plans	$2,723

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