Emergency visit, high (level 4) at Evans Memorial Hospital. CPT 99284.
What Evans Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 26, 2026.
Outpatient / ER
—cash price (self-pay)
$1,400list price
$216–$1,190range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Caresource Medicaid | HMO | $216 |
| Amerigroup Medicaid | HMO | $221 |
| Peach State Medicaid | HMO | $221 |
| Humana Medicare | HMO | $364 |
| Ambetter | EPO | $473 |
| Caresource Commercial | EPO | $509 |
| BCBS PPO | PPO | $791 |
| Cigna | PPO | $840 |
| United Healthcare | PPO | $910 |
| BCBS HMO/Pathway | HMO | $1,067 |
| Aetna Commercial | PPO | $1,190 |
Inpatient
—cash price (self-pay)
$1,400list price
$910–$962range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | PPO | $910 |
| Cigna | PPO | $962 |
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