Emergency visit, high (level 4) at Mercy San Juan Medical Center. CPT 99284.
What Mercy San Juan Medical Center publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$1,169cash price (self-pay)
$12,180list price
$98.04–$18,486range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United | Medicaid|< 21 | $98.04 |
| Hill Physicians | Medicaid|All Plans | $108 |
| Hill Physicians | Commercial|All Plans | $118 |
| Molina | Medicaid|All Plans | $129 |
| BCBS - Anthem | Medicaid|All Plans | $186 |
| California Health & Wellness | Medicaid|All Plans | $225 |
| Health Net | Medicaid|All Plans | $225 |
| Partnership Health Plan | Medicaid|All Plans | $422 |
| Humana | Commercial|All Plans | $560 |
| BrightHealth | Commercial|All Plans | $616 |
| Prison Healthcare | Medicaid|All Plans | $839 |
| WCMG | Commercial|All Plans | $1,340 |
| Western Health Advantage | Commercial|All Plans | $4,263 |
| Kaiser | Medicaid|All Plans | $4,994 |
| Blue Shield CA | Commercial|ACO Trio | $6,455 |
| Health Net | Commercial|EPPO | $8,011 |
| Cigna | Commercial|LocalPlus | $8,038 |
| Blue Shield CA | Commercial|ACO Trio CalPers | $8,160 |
| Kaiser | Commercial|All Plans | $8,891 |
| First Health | Commercial|All Plans | $9,135 |
| Healthsmart | Commercial|All Plans | $9,135 |
| Blue Shield CA | Commercial|Exchange | $9,500 |
| Aetna | Commercial|All Other Plans | $9,622 |
| Aetna | Commercial|HMO | $9,622 |
| Aetna | Commercial|PPO | $9,622 |
| Sutter Health | Commercial|All Plans | $9,744 |
| Blue Shield CA | Commercial|PPO Tandem | $10,109 |
| MultiPlan | Commercial|All Plans | $10,109 |
| BCBS - Anthem | Commercial|Connection EPO | $10,530 |
| Cigna | Commercial|All Other Plans | $10,718 |
Inpatient
$1,169cash price (self-pay)
$12,180list price
$469–$16,677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| WCMG | Commercial|All Plans | $1,340 |
| First Health | Commercial|All Plans | $9,135 |
| Healthsmart | Commercial|All Plans | $9,135 |
| Sutter Health | Commercial|All Plans | $9,744 |
| MultiPlan | Commercial|All Plans | $10,109 |
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