Emergency visit, high (level 4) at Santa Rosa Medical Center. CPT 99284.
What Santa Rosa Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$919cash price (self-pay)
$6,127list price
$115–$5,883range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Veterans Eval Services | Veterans Eval Services | $120 |
| Amerigroup Medicaid | Amerigroup Medicaid FL | $126 |
| FL Community Care | FL Community Care | $133 |
| NODE Humana MCR PPO PFFS | NODE Humana MCR PPO PFFS | $407 |
| NODE Tricare | NODE Tricare | $414 |
| NODE Aetna MCR ADV | NODE Aetna MCR ADV | $429 |
| Node BCBS FL Mcr Adv | Node BCBS FL Mcr Adv | $429 |
| NODE Cigna Healthspring MCR ADV | NODE Cigna Healthspring MCR ADV | $429 |
| NODE Humana MCR HMO POS | NODE Humana MCR HMO POS | $429 |
| NODE Medicare Non Par | NODE Medicare Non Par | $429 |
| NODE Medicare Traditional | NODE Medicare Traditional | $429 |
| Node UHC Mcr Adv | Node UHC Mcr Adv | $429 |
| NODE ChampVA | NODE ChampVA | $436 |
| Hospice of NW FL | Hospice of NW FL | $436 |
| NODE United Optum VA CCN | NODE United Optum VA CCN | $436 |
| Node Va | Node Va | $436 |
| NODE Wellcare MCR ADV | NODE Wellcare MCR ADV | $450 |
| GEO Group | GEO Group | $545 |
| NODE US Dept of Labor | NODE US Dept of Labor | $545 |
| Prime Health Work Comp FL | Prime Health Work Comp FL | $853 |
| Florida Workers Compensation | FL Work Comp | $879 |
| SUNSHINE HEALTH AMBETTER MARKETPLACE | Sunshine State Health Plan Comm | $1,041 |
| CHS Group Health Plan UMR | CHS Group Health Plan UMR | $1,189 |
| Oscar | Oscar | $1,313 |
| Cigna | Cigna ALL | $1,385 |
| Self Pay | Self Pay | $1,409 |
| Blue Cross and Blue Shield of Florida | BCBS FL BSL | $2,083 |
| Blue Cross and Blue Shield of Florida | BCBS FL MBN | $2,083 |
| Blue Cross and Blue Shield of Florida | BCBS FL HMO | $2,199 |
| BCBS FL Sbn | BCBS FL Sbn | $2,199 |
Inpatient
$2,144cash price (self-pay)
$6,127list price
$1,189–$4,901range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan UMR | CHS Group Health Plan UMR | $1,189 |
| Cigna | Cigna ALL | $1,385 |
| Self Pay | Self Pay | $1,409 |
| Aetna Health | Aetna INTL Passport | $3,437 |
| Prime Health Services | Prime Health | $4,901 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.