Emergency visit, high (level 4) at Saint Francis Hospital and Medical Center. CPT 99284.
What Saint Francis Hospital and Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$12.06–$5,748range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Aetna Medicare Advantage | $490 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $490 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $495 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $500 |
| Fallon Health Medicare Advantage | Fallon Medicare Advantage | $500 |
| Commonwealth Care Alliance Medicare | Commonwealth Care Alliance Medic | $500 |
| Cigna Medicare Advantage | Cigna Medicare Advantage | $505 |
| Wellcare Medicare | Wellcare Medicare Advantage | $510 |
| Fallon Health Medicare Advantage | Fallon Navicare Medicare Advantage | $515 |
| Centivo | Centivo | $1,000 |
| Innovative Health Plan II | Innovative Health Plan | $1,050 |
| Health New England | Health New England | $1,648 |
| Blue Cross Domestic | Anthem | $1,739 |
| Bcn Domestic | Anthem | $1,739 |
| Blue Care Network | Anthem | $1,739 |
| Blue Shield - NY Highmark Northeastern | Anthem | $1,739 |
| Blue Cross - Ok | Anthem | $1,739 |
| Blue Cross - Pa (Capital) | Anthem | $1,739 |
| Blue Cross - Pa (Independence) | Anthem | $1,739 |
| Blue Cross - Or (Regence) | Anthem | $1,739 |
| Blue Cross - Nj (Horizon) | Anthem | $1,739 |
| Blue Cross - Nm | Anthem | $1,739 |
| Blue Cross - De (Highmark) | Anthem | $1,739 |
| Blue Cross - Dc (Carefirst) | Anthem | $1,739 |
| Blue Cross - Md (Carefirst) | Anthem | $1,739 |
| Blue Cross - Ri | Anthem | $1,739 |
| Blue Shield - Pa (Highmark) | Anthem | $1,739 |
| Blue Cross - Tn | Anthem | $1,739 |
| Blue Cross - Sc | Anthem | $1,739 |
| Blue Cross - TX | Anthem | $1,739 |
Inpatient
$384cash price (self-pay)
$384list price
$60.09–$384range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ascension St. Vincent Public Safety Medical | Medicaid | $60.09 |
| Cmh Kalamazoo | Medicaid | $60.09 |
| Stephenson Cty Health | Medicaid | $60.09 |
| Delaware County Department Of Health | Medicaid | $60.09 |
| Ryan White Florida Mssrp | Medicaid | $60.09 |
| Idaho Dept Health And Wellfare | Medicaid | $60.09 |
| Can Community Health Inc | Medicaid | $60.09 |
| Capital District Physicians Health Medicaid Advantage | Medicaid | $60.09 |
| Medicaid Advantage Generic | Medicaid | $60.09 |
| Affinity Health Plan Medicaid Advantage | Medicaid | $60.09 |
| Community Benefit Health | Medicaid | $60.09 |
| Health New England Medicaid Advantage | Medicaid | $60.09 |
| Highmark Wholecare Medicaid | Medicaid | $60.09 |
| Dscc | Medicaid | $60.09 |
| Blue Cross - Nj (Horizon) Medicaid Advantage | Medicaid | $60.09 |
| Veterans Eval Services | Tricare | $99.57 |
| Molina Medicare Advantage | Medicare | $103 |
| Rx Allwin | Medicare | $103 |
| Longevity Health Plan | Medicare | $103 |
| Medicare Alternate Payor | Medicare | $103 |
| Genex Wc | Workers Comp | $175 |
| Wc Generic | Workers Comp | $175 |
| Health Smart | Healthsmart | $326 |
| Blue Shield - NY Highmark Western | Anthem BCBS | $381 |
| Blue Cross - Nm | Anthem BCBS | $381 |
| Blue Cross - NY (Anthem) | Anthem BCBS | $381 |
| Blue Cross - Nh (Anthem) | Anthem BCBS | $381 |
| Blue Cross - Nj (Horizon) | Anthem BCBS | $381 |
| Blue Cross - Mt | Anthem BCBS | $381 |
| Blue Cross - Nv (Anthem) | Anthem BCBS | $381 |
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All common services at Saint Francis Hospital and Medical Center