Emergency visit, high (level 4) at White Memorial Medical Center. CPT 99284.
What White Memorial Medical Center publishes for this service, straight from its standard-charges file, last updated May 23, 2026.
Outpatient / ER
$76.14cash price (self-pay)
$423list price
$68.35–$8,242range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Access Medi-Cal | Access Medi-Cal | $68.35 |
| Care First Medi-Cal | Care First Medi-Cal | $68.35 |
| Healthcare Inc Medi-Cal | Healthcare Inc Medi-Cal | $68.35 |
| Pacific Ipa Medi-Cal | Pacific Ipa Medi-Cal | $68.35 |
| Altamed Medi-Cal - All Other Plans | Altamed Medi-Cal - All Other Plan | $68.35 |
| Healthnet Mcal | Healthnet Mcal | $81.40 |
| Fcs Ipa Medi-Cal Op/Profee Only | Fcs Ipa Medi-Cal Op/Profee Only | $82.02 |
| Ahp Medi-Cal | Ahp Medi-Cal | $95.69 |
| Access Group | Access Group | $103 |
| Lasalle Mg Commercial - All Other Plans | Lasalle Mg Commercial - All | $103 |
| Molina Medi-Cal | Molina Medi-Cal | $109 |
| Aetna - All Plans | Aetna - All Plans | $111 |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | Bella Vista Mcr A | $121 |
| Brand New Day Mcare - All Plans | Brand New Day Mcare - All Plans | $121 |
| Care First Mcare - All Other Plans | Care First Mcare - All Other Plan | $121 |
| Caremore Mcare - All Plans | Caremore Mcare - All Plans | $121 |
| Lasalle Mg Senior | Lasalle Mg Senior | $121 |
| Pacific Alliance Mcare - All Other Plans | Pacific Alliance Mcare - Al | $121 |
| Preferred Senior | Preferred Senior | $121 |
| Scan Health Mcare - All Plans | Scan Health Mcare - All Plans | $121 |
| Sunlight Living Hlth Mcr Adv-All Other Plans | Sunlight Living Hlth Mc | $121 |
| Tricare Blue Shield-All Plans | Tricare Blue Shield-All Plans | $121 |
| Access Senior - All Other Plans | Access Senior - All Other Plans | $121 |
| Ahp - All Other Plans | Ahp - All Other Plans | $121 |
| Ahp Senior | Ahp Senior | $121 |
| Altamed Connect | Altamed Connect | $121 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $123 |
| Fcs Ipa Op/Profee Only - All Other Plans | Fcs Ipa Op/Profee Only - Al | $127 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $133 |
| Cigna All Other - All Other Plans | Cigna All Other - All Other Plans | $138 |
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