Emergency visit, high (level 4) at Southern California Hospital at Hollywood. CPT 99284.

What Southern California Hospital at Hollywood publishes for this service, straight from its standard-charges file, last updated March 18, 2026.

Outpatient / ER

—cash price (self-pay)

—list price

$5.57–$2,387range insurers pay

Insurance plan	Negotiated rate
Blue Shield of California \| Covered California/IFP/PPO	$5.57
Blue Shield of California \| HMO	$6.38
Blue Shield of California \| EPO/PPO/Out of State	$6.95
Blue Shield Promise \| Medi-Cal	$68.35
Health Net of California \| Managed Medi-Cal	$75.19
Aids Healthcare Foundation \| Managed Medi-Cal	$95.69
Aetna \| All Gatekeeper Plans	$251
Aetna \| All Non-Gatekeeper Plans	$251
Aetna \| Medicare Advantage	$426
Alignment Health Plan \| Medicare Advantage	$426
Central Health Plan \| Medicare Advantage	$426
Health Net of California \| Medicare Advantage	$426
Kaiser \| Medicare Advantage/Medi-Cal	$426
LA Care \| Medicare Advantage/Covered California	$426
Legacy Health Plan \| Medicare Advantage	$426
Molina \| Medicare Advantage	$426
Optum Health \| Commercial HMO	$426
United Healthcare \| Medicare Advantage	$426
Anthem Blue Cross \| Medicare Advantage	$426
Blue Shield of California \| Medicare Advantage	$426
Humana \| Medicare Advantage	$426
Bright Health \| Medicare Advantage	$434
Aids Healthcare Foundation \| Medicare Advantage	$434
Easy Choice (WellCare) \| Medicare Advantage	$434
Imperial Health Plan \| Medicare Advantage	$434
Optum Health \| Medicare Advantage	$434
Clever Care \| Medicare Advantage	$434
Patient Choice \| Medicare Advantage	$447
Prime Health Services \| Medicare Advantage	$447
Bright Health \| Covered California	$468

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