Emergency visit, high (level 4) at Saint Agnes Medical Center. CPT 99284.
What Saint Agnes Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$4.86–$3,979range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medi-Cal Blue Cross | Anthem Medicaid | $39.22 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $526 |
| Humana Medicare Advantage | Humana Ipa Meritage Medicare Advantage | $526 |
| Blue Cross - CA (Anthem) Medicare Advantage | Anthem BCBS Medicare Adv | $526 |
| Humana Central Valley Medpro | Cvhp | $537 |
| Healthnet Medicare Advantage | Healthnet Medicare Advantage | $548 |
| Welbe Health | Welbe Health | $552 |
| Kaiser Permanente Medicare Advantage | Kaiser Medicare Advantage | $553 |
| Brand New Day Medicare Advantage | Brand New Day Medicare Advantage | $553 |
| Healthnet Medicare Advantage | Key Medical Group | $553 |
| Central Health Medicare Advantage | Central Health Plan Medicare Advan | $553 |
| Humana Medicare Advantage | Key Medical Group | $553 |
| Wellcare Medicare | Care1st Health Medicare Advantage | $553 |
| Align Senior Care | Ally Senior Care Medicare Advantage | $617 |
| Kaiser Permanente | Kaiser HMO | $939 |
| Blue Cross - Mo (Anthem) | Anthem Bc HMO | $1,113 |
| Blue Cross - Ne | Anthem Bc HMO | $1,113 |
| Blue Cross - Wi (Anthem) | Anthem Bc HMO | $1,113 |
| Blue Cross - Va (Carefirst) | Anthem Bc HMO | $1,113 |
| Geha | United Healthcare Choice | $2,547 |
| Healthnet | Health Net Pnnc | $2,691 |
| Healthnet | Health Net PPO | $2,884 |
| Coventry | Coventry | $2,978 |
| Cba Network By Design | Networks By Design | $3,247 |
| Cigna | Cigna | $3,338 |
| Meritain | Meritain | $3,531 |
| Phcs | Multiplan | $3,636 |
| Multiplan | Multiplan | $3,636 |
| Aetna | Aetna | $3,728 |
| Allied Benefit Systems | Aetna | $3,728 |
Inpatient
$296cash price (self-pay)
$296list price
$68.35–$266range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Ri | Medicaid | $68.35 |
| Medicaid - Pa | Medicaid | $68.35 |
| Medicaid - Tn | Medicaid | $68.35 |
| Medicaid - Sd | Medicaid | $68.35 |
| Medicaid - Sc | Medicaid | $68.35 |
| Medicaid - Vt | Medicaid | $68.35 |
| Medicaid - Nd | Medicaid | $68.35 |
| Medicaid - Nc | Medicaid | $68.35 |
| Medicaid - NY | Medicaid | $68.35 |
| Medicaid - Ok | Medicaid | $68.35 |
| Medicaid - Oh | Medicaid | $68.35 |
| Medicaid - Nv | Medicaid | $68.35 |
| Chhuny | Medicaid | $68.35 |
| Capital District Physicians Health Medicaid Advantage | Medicaid | $68.35 |
| Medicaid Advantage Generic | Medicaid | $68.35 |
| Independent Care Medicaid | Medicaid | $68.35 |
| Delta Dental Nj | Medicaid | $68.35 |
| Freedom First Healthcare | Medicaid | $68.35 |
| Keystone First Chc Medicaid | Medicaid | $68.35 |
| Maryland Physicians Care | Medicaid | $68.35 |
| Simply Healthcare Medicaid | Medicaid | $68.35 |
| Medicaid - Or | Medicaid | $98.13 |
| Molina Medicare Advantage | Medicare | $113 |
| Rx Allwin | Medicare | $113 |
| Pace Southeast | Medicare | $113 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Medicare | $113 |
| Carefirst Medicare Advantage | Medicare | $113 |
| Blue Cross - Or (Regence) Medicare Advantage | Medicare | $113 |
| BCBS Medicare Advantage Generic | Medicare | $113 |
| Lasso Healthcare Msa | Medicare | $113 |
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