Emergency visit, high (level 4) at Dallas County Hospital. CPT 99284.
What Dallas County Hospital publishes for this service, straight from its standard-charges file, last updated May 29, 2026.
Outpatient / ER
$316cash price (self-pay)
$1,077list price
$108–$993range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare B IA J5 | Default | $108 |
| AmeriGroup Wellpoint | Default | $275 |
| Iowa Total Care MCD Adv (active 7/1/19) | Default | $275 |
| Medicaid Iowa | Default | $275 |
| Molina Healthcare of Iowa MCD Rep | Default | $275 |
| Aetna Medicare Advantage | Default | $486 |
| Humana | Medicare Advantage | $486 |
| Medicare A IA J5 | Default | $486 |
| United Healthcare | Medicare Advantage | $495 |
| United Healthcare | Default | $954 |
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