Emergency visit, highest (level 5) at Johnson Memorial Hospital. CPT 99285.
What Johnson Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$388cash price (self-pay)
$2,362list price
$99.99–$6,550range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Evernorth | $527 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $700 |
| Medigold Medicare Advantage | Mount Carmel Health Plan Medicare Adv | $700 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $700 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $707 |
| Fallon Health Medicare Advantage | Fallon Medicare Advantage | $714 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $714 |
| Commonwealth Care Alliance Medicare | Commonwealth Care Alliance Medic | $714 |
| Wellcare Medicare | Wellcare Medicare Advantage | $714 |
| Cigna Medicare Advantage | Cigna Medicare Advantage | $721 |
| Prime Health Services Medicare Advantage | Prime Health Medicare Advan | $728 |
| Fallon Health Medicare Advantage | Fallon Navicare Medicare Advantage | $735 |
| Claimdoc | Claimdoc | $1,499 |
| Innovative Health Plan II | Innovative Health Plan | $1,499 |
| Centivo | Centivo | $1,663 |
| Kaiser Domestic | Anthem | $2,158 |
| Blue Cross - Pa (Independence) | Anthem | $2,158 |
| Blue Cross - Pa (Capital) | Anthem | $2,158 |
| Blue Cross - Ok | Anthem | $2,158 |
| Blue Cross - Or (Regence) | Anthem | $2,158 |
| Blue Cross - Nc | Anthem | $2,158 |
| Blue Cross - Ut (Regence) | Anthem | $2,158 |
| Blue Cross - Vt | Anthem | $2,158 |
| Blue Cross - Va (Anthem) | Anthem | $2,158 |
| Blue Cross - Mi | Anthem | $2,158 |
| Blue Shield - Wa (Regence) | Anthem | $2,158 |
| Blue Cross - Nd | Anthem | $2,158 |
| Blue Cross - Wa (Premera) | Anthem | $2,158 |
| Blue Cross - Sd (Wellmark) | Anthem | $2,158 |
| Blue Cross - IL Alternate | Anthem | $2,158 |
Inpatient
$552cash price (self-pay)
$552list price
$99.99–$552range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Care Oregon Ohp | Medicaid | $99.99 |
| Amerigroup Medicaid | Medicaid | $99.99 |
| Molina Medicare Advantage | Medicare | $175 |
| Rx Allwin | Medicare | $175 |
| Blue Shield - NY Highmark Northeastern Medicare Advantage | Medicare | $175 |
| Preferred Care Partners | Medicare | $175 |
| Medicare Advantage Generic | Medicare | $175 |
| Blue Cross - Wv (Highmark) Medicare Advantage | Medicare | $175 |
| Allwell Pa Health & Wellness Medicare Advantage | Medicare | $175 |
| Michigan Complete Health | Medicare | $175 |
| Optimum Healthcare Medicare Advantage | Medicare | $175 |
| Kaiser Permanente Medicare Advantage | Medicare | $175 |
| Unicare Medicare Advantage | Medicare | $175 |
| Um Health Advantage | Medicare | $175 |
| Aurora Special Needs | Medicare | $175 |
| Tufts Medicare Advantage | Tufts Medicare Advantage | $175 |
| Blue Shield - NY Highmark Western Medicare Advantage | Medicare | $175 |
| Moda Health Medicare Advantage | Medicare | $175 |
| Blue Cross - CA (Anthem) Medicare Advantage | Medicare | $175 |
| Blue Cross - Oh (Anthem) Medicare Advantage | Medicare | $175 |
| Amerihealth Medicare | Medicare | $175 |
| Veterans Administration | Veterans Affairs | $179 |
| Wc Johns Eastern | Workers Comp | $255 |
| Wc Guard Insurance Company | Workers Comp | $255 |
| Wc Broadspire | Workers Comp | $255 |
| Wc North American Rishces | Workers Comp | $255 |
| Wc Zenith | Workers Comp | $255 |
| Wc Amtrust | Workers Comp | $255 |
| Wc Align Network | Workers Comp | $255 |
| Wc Cna | Workers Comp | $255 |
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