Emergency visit, high (level 4) at St Helena Hospital. CPT 99284.
What St Helena Hospital publishes for this service, straight from its standard-charges file, last updated July 15, 2026.
Outpatient / ER
$66.15cash price (self-pay)
$441list price
$53.83–$6,353range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medi-Cal | Medi-Cal | $53.83 |
| Va Medi-Cal | Va Medi-Cal | $98.04 |
| Blue Shield Bh Mcr Adv | Blue Shield Bh Mcr Adv | $123 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $123 |
| Tricare Blue Shield | Tricare Blue Shield | $123 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $123 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $135 |
| Cigna-All Other Plans | Cigna-All Other Plans | $143 |
| Interplan-All Plans | Interplan-All Plans | $148 |
| Kaiser-All Other Plans | Kaiser-All Other Plans | $148 |
| UHC Jll | UHC Jll | $154 |
| UHC Options PPO | UHC Options PPO | $154 |
| UHC Select/Select Plus | UHC Select/Select Plus | $154 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $154 |
| Aetna-All Plans | Aetna-All Plans | $176 |
| Western Growers-All Plans | Western Growers-All Plans | $176 |
| Blue Shield Epn-All Other Plans | Blue Shield Epn-All Other Plans | $178 |
| Blue Shield Non-Epn | Blue Shield Non-Epn | $188 |
| Blue Cross Mcs - All Other Plans | Blue Cross Mcs - All Other Plans | $227 |
| Blue Cross Non Mcs | Blue Cross Non Mcs | $227 |
| Phcs-All Plans | Phcs-All Plans | $243 |
| Health Management Network-All Plans | Health Management Network-All Pl | $375 |
| Three Rivers-All Plans | Three Rivers-All Plans | $397 |
| UHC Mcr Adv | UHC Mcr Adv | $554 |
| Va Mcr - All Other Plans | Va Mcr - All Other Plans | $554 |
| Blue Cross Exchange | Blue Cross Exchange | $2,882 |
| Blue Shield Behav Hlth | Blue Shield Behav Hlth | $3,177 |
| Healthnet-All Plans | Healthnet-All Plans | $4,328 |
| Umr UHC PPO | Umr UHC PPO | $4,493 |
| Choicecare-All Plans | Choicecare-All Plans | $4,941 |
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