Emergency visit, high (level 4) at St. Mary's Medical Center. CPT 99284.
What St. Mary's Medical Center publishes for this service, straight from its standard-charges file, last updated March 22, 2026.
Outpatient / ER
—cash price (self-pay)
$2,559list price
$428–$5,100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS/Anthem | BCBS Co Pathway | $890 |
| BCBS/Anthem | BCBS Co Exchange Plan | $970 |
| BCBS/Anthem | BCBS Co Federal | $970 |
| BCBS/Anthem | BCBS Co HMO | $970 |
| BCBS/Anthem | BCBS Co Indemnity | $970 |
| BCBS/Anthem | BCBS Co PPO | $970 |
| Monument Health | UHC Rocky Monument Exchange HMO | $1,281 |
| Monument Health | UHC Rocky Monument Exchange HMO HDHP | $1,281 |
| Monument Health | UHC Rocky Monument Ind HMO | $1,281 |
| Monument Health | UHC Rocky Monument Ind HMO HDHP | $1,281 |
| Cigna | Cigna Local Plus | $1,579 |
| Cigna | Cigna HMO | $1,757 |
| Cigna | Cigna Indemnity | $1,757 |
| Cigna | Cigna Other | $1,757 |
| Cigna | Cigna POS/Qpos | $1,757 |
| Cigna | Cigna PPO | $1,757 |
| Cigna | Eighth Dist Elect Ben Pln | $1,757 |
| Cigna | Health-Partners | $1,757 |
| Allegiance | Cigna Sclhs Employees | $1,830 |
| Cigna Scl Employees | Cigna Sclhs Cdhp | $1,830 |
| Aetna | Aetna Colorado Preferred | $1,929 |
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $2,076 |
| Kaiser Perm PPO/POS | Kaiser PPO/POS Other | $2,076 |
| Aetna | Aetna HMO/EPO | $2,142 |
| Aetna | Aetna Indemnity | $2,142 |
| Aetna | Aetna POS/Qpos | $2,142 |
| Aetna | Aetna PPO | $2,142 |
| Aetna | Aetna Src | $2,142 |
| Geha | Geha-Asa | $2,142 |
| Meritain Health | Meritain Health | $2,142 |
Inpatient
—cash price (self-pay)
$2,559list price
$1,025–$2,482range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | UHC Rocky Mountain HMO | $1,025 |
| Umr United Med Resources | Umr Mesa Cnty Valley School Dist 51 | $1,228 |
| Monument Health | UHC Rocky Monument Exchange HMO | $1,281 |
| Monument Health | UHC Rocky Monument Exchange HMO HDHP | $1,281 |
| Monument Health | UHC Rocky Monument Ind HMO | $1,281 |
| Monument Health | UHC Rocky Monument Ind HMO HDHP | $1,281 |
| Monument Health | Umr Monument Health Network | $1,281 |
| Cigna | Cigna Local Plus | $1,579 |
| Cigna | Cigna HMO | $1,757 |
| Cigna | Cigna Indemnity | $1,757 |
| Cigna | Cigna Other | $1,757 |
| Cigna | Cigna POS/Qpos | $1,757 |
| Cigna | Cigna PPO | $1,757 |
| Cigna | Eighth Dist Elect Ben Pln | $1,757 |
| Cigna | Health-Partners | $1,757 |
| Allegiance | Cigna Sclhs Employees | $1,830 |
| Cigna Scl Employees | Cigna Sclhs Cdhp | $1,830 |
| Aetna | Aetna Colorado Preferred | $1,929 |
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $2,076 |
| Kaiser Perm PPO/POS | Kaiser PPO/POS Other | $2,076 |
| Aetna | Aetna HMO/EPO | $2,142 |
| Aetna | Aetna Indemnity | $2,142 |
| Aetna | Aetna POS/Qpos | $2,142 |
| Aetna | Aetna PPO | $2,142 |
| Aetna | Aetna Src | $2,142 |
| Geha | Geha-Asa | $2,142 |
| Meritain Health | Meritain Health | $2,142 |
| Choicecare Humana | Choicecare Humana HMO EPO | $2,252 |
| Choicecare Humana | Choicecare Humana PPO | $2,252 |
| Choicecare Humana | Choicecare Humana Secondary Other | $2,252 |
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