Emergency visit, high (level 4) at Fairview Park Hospital. CPT 99284.
What Fairview Park Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$2,517cash price (self-pay)
$2,517list price
$165–$3,649range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Peach State | MGMCD | $165 |
| Wellcare | MCD | $165 |
| Amerigroup | MCD | $250 |
| Memorial Health Plan | EMPLOYEEPLAN | $554 |
| Aetna Better Health of Georgia | MCD | $565 |
| Peach State (Ambetter) | HIX | $614 |
| United | OptionsPPO | $622 |
| Leavitt Risk Partners | COMM | $755 |
| Memorial Health Plan | HEALTHGRAM | $856 |
| Memorial Health Plan | COMM | $931 |
| Prime Health | WORKERSCOMP | $1,071 |
| Employer's Health Network | WCOMP | $1,093 |
| Rockport United Network | WORKERSCOMP | $1,093 |
| Identity MCO | WorkersComp | $1,115 |
| Synergy Health Network | WorkersComp | $1,115 |
| United | GlobalBenefitPlan | $1,133 |
| Dodge County Hospital | COMM | $1,258 |
| Aetna | NAP | $1,387 |
| Health One Alliance | COMMHIX | $1,680 |
| Memorial Health Plan | CORECOMMUNITYCARE | $2,115 |
| Memorial Health Plan | COASTALHEALTHPLAN | $2,135 |
| American Steel Products | COMM | $2,139 |
| MultiPlan | Complementary | $2,265 |
| MultiPlan | Primary | $2,265 |
| NovaNet | COMM | $2,265 |
| Friday Health | HIX | $2,320 |
| Cigna | LocalPlus | $2,598 |
| Cigna | HMO | $2,676 |
| Cigna | OAP | $2,676 |
| Cigna | PPO | $2,676 |
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