Emergency visit, high (level 4) at Straub Benioff Medical Center. CPT 99284.
What Straub Benioff Medical Center publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$1,734cash price (self-pay)
$2,890list price
$417–$2,527range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Alohacare | Medicare Advantage | $417 |
| Hmsa | Medicare Advantage | $417 |
| Mdx | Humana Medicare | $417 |
| Mdx | UHC Medicare | $417 |
| Ohana | Medicare Advantage | $426 |
| Devoted | Medicare Advantage | $438 |
| Ohana | Quest - Non-Abd | $505 |
| Alohacare | Non-Abd - Pediatric | $580 |
| Alohacare | Non-Abd - Adult | $580 |
| Hmsa | Quest Non-Abd | $780 |
| Hmsa | Quest Abd | $1,100 |
| UHC | All Products | $1,247 |
| Blended Rate UHC | All Products | $1,387 |
| Hmsa | All Products | $1,460 |
| Alohacare | Abd - Pediatric | $1,624 |
| Alohacare | Abd - Adult | $1,624 |
| Ohana | Quest - Abd | $1,656 |
| Calvos | Select Care | $2,168 |
| Mimoh | All Products | $2,168 |
| Hwmg/Hmaa | All Products | $2,306 |
| Hcha | All Products | $2,312 |
| Kaiser | All Products | $2,312 |
| Mdx | All Products | $2,312 |
| Pac Admin | All Products | $2,312 |
| Verdegard | Union Trust Fund | $2,312 |
| Multiplan | All Products | $2,457 |
| Uha | All Products | $2,527 |
Inpatient
$1,734cash price (self-pay)
$2,890list price
$1,387–$2,457range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Multiplan | All Products | $2,312 |
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