Emergency visit, high (level 4) at Adair County Memorial Hospital. CPT 99284.
What Adair County Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 2, 2026.
Outpatient / ER
$555cash price (self-pay)
$1,145list price
$110–$1,203range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $203 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $204 |
| UHC Mcr Adv | UHC Mcr Adv | $414 |
| UHC Va Ccn | UHC Va Ccn | $414 |
| Mahp-All Plans | Mahp-All Plans | $555 |
| Centivo-All Plans | Centivo-All Plans | $622 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $718 |
| Iowa Total Care-All Plans | Iowa Total Care-All Plans | $721 |
| Aetna Whole Health - All Plans | Aetna Whole Health - All Plans | $744 |
| UHC-All Other Plans | UHC-All Other Plans | $916 |
| Geha-All Plans | Geha-All Plans | $1,088 |
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