Emergency visit, high (level 4) at Ukiah Adventist Hospital. CPT 99284.
What Ukiah Adventist Hospital publishes for this service, straight from its standard-charges file, last updated May 24, 2026.
Outpatient / ER
$51.40cash price (self-pay)
$5,106list price
$53.83–$20,291range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser Medi-Cal | Kaiser Medi-Cal | $98.04 |
| Medi-Cal | Medi-Cal | $98.04 |
| Blue Cross Mcs-All Other Plans | Blue Cross Mcs-All Other Plans | $139 |
| Blue Cross Non-Mcs | Blue Cross Non-Mcs | $139 |
| Western Growers-All Plans | Western Growers-All Plans | $198 |
| Healthnet-All Plans | Healthnet-All Plans | $200 |
| Cigna-All Plans | Cigna-All Plans | $257 |
| Mendocino Lcc District-All Plans | Mendocino Lcc District-All Plans | $262 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $280 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $280 |
| Tricare Blue Shield-All Plans | Tricare Blue Shield-All Plans | $280 |
| Kaiser-All Other Plans | Kaiser-All Other Plans | $322 |
| Three Rivers-All Plans | Three Rivers-All Plans | $363 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $505 |
| UHC Mcr Adv | UHC Mcr Adv | $575 |
| Blue Cross Exchange | Blue Cross Exchange | $2,049 |
| UHC Jll Csp 1/1/25 | UHC Jll Csp 1/1/25 | $2,094 |
| UHC All Payer-All Other Plans | UHC All Payer-All Other Plans | $2,211 |
| Foundation For Medical Care-All Plans | Foundation For Medical Care-Al | $3,830 |
| Networks By Design-All Plans | Networks By Design-All Plans | $4,085 |
| Phcs Multiplan-All Plans | Phcs Multiplan-All Plans | $4,085 |
| Interplan-All Plans | Interplan-All Plans | $4,187 |
| Beech Street-All Plans | Beech Street-All Plans | $4,340 |
| Choice Care-All Plans | Choice Care-All Plans | $4,340 |
| Health Mgmt Network-All Plans | Health Mgmt Network-All Plans | $4,340 |
| Blue Shield Epn-All Other Plans | Blue Shield Epn-All Other Plans | $4,922 |
| Blue Shield Non-Epn | Blue Shield Non-Epn | $5,014 |
| Aetna-All Plans | Aetna-All Plans | $9,543 |
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