Emergency visit, moderate (level 3) at Good Samaritan Hospital. CPT 99283.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$7,104cash price (self-pay)
$7,104list price
$63.97–$7,104range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Physicians Medical Group | MCD | $63.97 |
| Physician Health Network | MGMCD | $70.37 |
| United | OptionsPPO | $1,812 |
| Bright Health | COMM | $1,924 |
| Aetna | AWH | $2,672 |
| Aetna | HMO | $2,727 |
| Aetna | PPO | $2,727 |
| Anthem | ExchangeEPO | $2,868 |
| Anthem | BlueConnection | $3,026 |
| Anthem | COMM | $3,026 |
| Blue Shield | COMM | $3,115 |
| Blue Shield | EPN | $3,115 |
| Cigna | LocalPlus | $3,188 |
| United | GlobalBenefitPlan | $3,197 |
| Cigna | HMO | $3,391 |
| Cigna | POS | $3,391 |
| Cigna | PPO | $3,391 |
| Santa Clara IPA COMM | COMM | $3,552 |
| Santa Clara IPA MCR | MCR | $3,552 |
| NX Health Network | COMM | $4,263 |
| Sutter Select | COMM | $4,263 |
| ChoiceCare Humana | COMM | $4,973 |
| First Health | COMM | $5,399 |
| Cigna BH | COMMBH | $5,683 |
| HealthSmart | WCOMP | $5,683 |
| Intercontinental Corporation | COMM | $5,683 |
| MultiPlan | Complementary | $5,683 |
| PHA Pacific Health Alliance | COMM | $5,683 |
| PPO Next | COMM | $5,683 |
| PPO Next | PPO | $5,683 |
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