Emergency visit, high (level 4) at La Palma Intercommunity Hospital. CPT 99284.
What La Palma Intercommunity Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$534cash price (self-pay)
$3,573list price
$98.04–$3,573range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield Of Promise | Blue Shield Of Promise Medi-Cal | $98.04 |
| Caloptima | Caloptima Medi-Cal IP | $98.04 |
| COUNTY OF ORANGE (MSN) | COUNTY OF ORANGE (MSN) Medi-Cal | $98.04 |
| LA Care Health Plan | L.A Care Health Plan Medi-Cal | $98.04 |
| Molina | Molina Medi-Cal | $98.04 |
| Traditional Medi - Cal | Traditional Medi-Cal | $98.04 |
| Anthem Blue Cross | Anthem Blue Cross Medi-Cal | $103 |
| Health Net of CA | Health Net Of CA Medi-Cal | $105 |
| Blue Shield Of Promise | Blue Shield Of Promise Medicare | $534 |
| Blue Shiled Of CA Triwest | Blue Shield of CA TriWest Healthcare VA | $534 |
| Health Net Federal Services Tricare | Health Net Federal Services Tric | $534 |
| Health Net of CA | Health Net Of CA Medicare | $534 |
| LA Care Health Plan | L.A Care Health Plan Covered Direct | $534 |
| LA Care Health Plan | L.A Care Health Plan Duals | $534 |
| Managed Health Network | Managed Health Network Medicare | $534 |
| Molina | Molina Exchange | $534 |
| Molina | Molina Medicare | $534 |
| Renal Payer Solutions | Renal Payor Solutions Medicare | $534 |
| Traditional Medicare | Traditional Medicare | $534 |
| Tricare | Tricare | $534 |
| Verda HealthPlan | Verda HealthPlan Medicare | $534 |
| Brand New Day | Brand New Day Medicare | $539 |
| Imperial Health Plan Of CA | Imperial Health Plan Of CA Medicare | $566 |
| COVENTRY fka AETNA Worker Comp | COVENTRY - fka AETNA - Workers Compen | $682 |
| CA FOUNDATION FOR MEDICAL CARE | CA FOUNDATION FOR MEDICAL CARE Worker | $704 |
| Workers Compensation | Workers Compensation | $704 |
| Employer Direct Healthcare | Employer Direct Healthcare Surgery Plus | $748 |
| Health Net of CA | Health Net Of CA Commercial PPO | $751 |
| Health Net of CA | Health Net Of CA Commercial Ins Exchange | $780 |
| Brand New Day | Brand New Day Exchange | $801 |
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