Emergency visit, high (level 4) at Jeff Davis Hospital. CPT 99284.
What Jeff Davis Hospital publishes for this service, straight from its standard-charges file, last updated May 26, 2026.
Outpatient / ER
$279cash price (self-pay)
$797list price
$155–$757range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid | Medicaid | $155 |
| Humana_medicaid | Medicaid | $159 |
| Peach_state | Commercial | $159 |
| Molina_medicaid | Medicaid | $160 |
| Pen_network | Medicare | $182 |
| Medicare | Medicare | $247 |
| Choicecare_medicare_ppo | Medicare | $250 |
| Humana_medicare_hmo | Medicare | $250 |
| Humana_medicare_pffs | Medicare | $250 |
| Humana_medicare_pos | Medicare | $250 |
| Humana_medicare_ppo | Medicare | $250 |
| Bcbs_medicare_advantage_hmo | Medicare | $252 |
| Bcbs_medicare_advantage_indemnity | Medicare | $252 |
| Bcbs_medicare_advantage_open_access | Medicare | $252 |
| Bcbs_medicare_advantage_par | Medicare | $252 |
| Bcbs_medicare_advantage_pos | Medicare | $252 |
| Bcbs_medicare_advantage_ppo | Medicare | $252 |
| Care_improvement_plus | Medicare | $252 |
| Amerigroup_medicaid | Medicaid | $427 |
| Coventry_hmo | Commercial | $558 |
| Coventry_pos | Commercial | $558 |
| Bcbs_hmo | Commercial | $598 |
| Bcbs_pos | Commercial | $598 |
| Bcbs_ppo | Commercial | $598 |
| Coventry_ppo | Commercial | $614 |
| Beech_street | Commercial | $638 |
| Care_source | Medicaid | $638 |
| Cigna | Commercial | $638 |
| One_health_ppo | Commercial | $638 |
| Choicecare | Commercial | $677 |
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