Emergency visit, high (level 4) at Dorminy Medical Center. CPT 99284.
What Dorminy Medical Center publishes for this service, straight from its standard-charges file, last updated May 6, 2026.
Outpatient / ER
$1,153cash price (self-pay)
$2,306list price
$364–$2,364range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Advantage | $364 |
| Humana Medicare Advantage | Advantage | $364 |
| Anthem Blue Cross Medicare Advantage | Advantage | $364 |
| United HealthCare Medicare Advantage | Advantage | $364 |
| HealthSmart | All Commercial Plans | $1,730 |
| Aetna Commercial | PPO/HMO | $1,845 |
| Provider Network of America | All Commercial Plans | $1,960 |
| Principal Edge Network | All Commercial Plans | $2,006 |
| United HealthCare Commercial | PPO/HMO | $2,006 |
| Cigna Commercial | PPO/HMO | $2,030 |
| Humana ChoiceCare | All Commercial Plans | $2,030 |
| Novanet | All Commercial Plans | $2,076 |
| Unicare | All Commercial Plans | $2,076 |
| PHCS | All Commercial Plans | $2,076 |
| MultiPlan | PPO/HMO | $2,076 |
| Three Rivers Provider Network | All Commercial Plans | $2,191 |
| Anthem BCBS PPO | PPO | $2,364 |
Inpatient
$1,153cash price (self-pay)
$2,306list price
$1,730–$2,191range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| HealthSmart | All Commercial Plans | $1,730 |
| Aetna Commercial | PPO/HMO | $1,845 |
| Provider Network of America | All Commercial Plans | $1,960 |
| Principal Edge Network | All Commercial Plans | $2,006 |
| United HealthCare Commercial | PPO/HMO | $2,006 |
| Cigna Commercial | PPO/HMO | $2,030 |
| Humana ChoiceCare | All Commercial Plans | $2,030 |
| Novanet | All Commercial Plans | $2,076 |
| Unicare | All Commercial Plans | $2,076 |
| PHCS | All Commercial Plans | $2,076 |
| MultiPlan | PPO/HMO | $2,076 |
| Three Rivers Provider Network | All Commercial Plans | $2,191 |
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