Emergency visit, high (level 4) at Jackson Memorial Hospital. CPT 99284.
What Jackson Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 23, 2026.
Outpatient / ER
$387cash price (self-pay)
$2,317list price
$349–$4,481range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare - All Plans | Tricare - All Plans | $349 |
| Leon Hlth Mcr - All Plans | Leon Hlth Mcr - All Plans | $392 |
| Centene Bh Mcr - All Plans | Centene Bh Mcr - All Plans | $436 |
| Doctors Hlthcare Mcr Adv - All Plans | Doctors Hlthcare Mcr Adv - All | $436 |
| Healthspring - All Plans | Healthspring - All Plans | $436 |
| Humana Mcr Adv | Humana Mcr Adv | $436 |
| Pace Mcr Adv | Pace Mcr Adv | $436 |
| Preferred Care - All Plans | Preferred Care - All Plans | $436 |
| UHC Mcr Adv | UHC Mcr Adv | $436 |
| Avmed Mcr Adv | Avmed Mcr Adv | $436 |
| Molina Mcare | Molina Mcare | $479 |
| Ambetter Exch - All Plans | Ambetter Exch - All Plans | $479 |
| Longevity Hp - All Plans | Longevity Hp - All Plans | $488 |
| Align Mcr Adv - All Plans | Align Mcr Adv - All Plans | $488 |
| Carelon Bh Mcaid | Carelon Bh Mcaid | $546 |
| Avmed Exchange | Avmed Exchange | $606 |
| Amerihealth Exch - All Other Plans | Amerihealth Exch - All Other Plan | $610 |
| Humana Behav Hlth | Humana Behav Hlth | $650 |
| Lifesynch Comm - All Other Plans | Lifesynch Comm - All Other Plans | $650 |
| Lifesynch Mcr Adv | Lifesynch Mcr Adv | $650 |
| Aetna International | Aetna International | $1,019 |
| Molina Exch - All Other Plans | Molina Exch - All Other Plans | $1,240 |
| Aetna Exchange | Aetna Exchange | $1,306 |
| Aetna First Hlth | Aetna First Hlth | $1,397 |
| Multiplan - All Plans | Multiplan - All Plans | $1,413 |
| Molina Mcaid | Molina Mcaid | $1,622 |
| Cigna Bh | Cigna Bh | $1,668 |
| Aetna Comm - All Other Plans | Aetna Comm - All Other Plans | $1,748 |
| Dimension Pho - All Plans | Dimension Pho - All Plans | $1,854 |
| UHC Indiv Exch | UHC Indiv Exch | $1,861 |
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