Emergency visit, high (level 4) at Lodi Memorial Hospital Association. CPT 99284.
What Lodi Memorial Hospital Association publishes for this service, straight from its standard-charges file, last updated August 2, 2026.
Outpatient / ER
$28.21cash price (self-pay)
$403list price
$68.35–$6,357range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bc Mcal | Bc Mcal | $68.35 |
| Celtic Ins Company - All Plans | Celtic Ins Company - All Plans | $68.35 |
| Kaiser Mcal | Kaiser Mcal | $68.35 |
| Medi-Cal | Medi-Cal | $68.35 |
| Hp Mcal Pro Fee | Hp Mcal Pro Fee | $75.19 |
| Healthnet Mcal | Healthnet Mcal | $82.02 |
| Hp Of San Joaquin Mcal | Hp Of San Joaquin Mcal | $82.02 |
| Alignment Health Plan (Ahp)-All Plans | Alignment Health Plan (Ahp)-Al | $116 |
| Blue Shield Mcare Adv | Blue Shield Mcare Adv | $116 |
| Healthnet Mcare | Healthnet Mcare | $116 |
| Hp Of San Joaquin Mcr Adv | Hp Of San Joaquin Mcr Adv | $116 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $116 |
| Knnex Health - All Plans | Knnex Health - All Plans | $116 |
| Tricare Blue Shield - All Plans | Tricare Blue Shield - All Plans | $116 |
| UHC Mcr Adv | UHC Mcr Adv | $116 |
| Hp Healthy Kids Pro Fee | Hp Healthy Kids Pro Fee | $122 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $127 |
| Cigna- All Plans | Cigna- All Plans | $132 |
| Aetna - All Plans | Aetna - All Plans | $138 |
| First Health- All Plans | First Health- All Plans | $139 |
| Beech Street- All Plans | Beech Street- All Plans | $151 |
| Hp Of San Joaquin PPO - All Other Plans | Hp Of San Joaquin PPO - All | $151 |
| Multiplan- All Plans | Multiplan- All Plans | $151 |
| Kaiser Commercial - All Other Plans | Kaiser Commercial - All Other Pl | $156 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $156 |
| Networks By Design- All Plans | Networks By Design- All Plans | $156 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $157 |
| UHC HMO | UHC HMO | $157 |
| UHC Jll | UHC Jll | $157 |
| Western Growers- All Plans | Western Growers- All Plans | $166 |
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