Emergency visit, high (level 4) at Davis County Hospital. CPT 99284.
What Davis County Hospital publishes for this service, straight from its standard-charges file, last updated July 24, 2026.
Outpatient / ER
$422cash price (self-pay)
$422list price
$110–$649range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark BCBS HMO | Wellmark BCBS HMO | $188 |
| Wellmark BCBS PPO - All Other Plans | Wellmark BCBS PPO - All Other Pl | $188 |
| Aetna Mcr Adv-All Plans | Aetna Mcr Adv-All Plans | $226 |
| Home State Hlth Exch - All Other Plans | Home State Hlth Exch - All Ot | $233 |
| Home State Hlth Mcr | Home State Hlth Mcr | $233 |
| Choicecare Mcr Adv | Choicecare Mcr Adv | $233 |
| Tricare-All Plans | Tricare-All Plans | $233 |
| Mt Carmel Hp-All Plans | Mt Carmel Hp-All Plans | $235 |
| Amerigroup Mcr Adv-All Other Plans | Amerigroup Mcr Adv-All Other Plan | $237 |
| American Hp Mcr Adv-All Plans | American Hp Mcr Adv-All Plans | $244 |
| Midlands Choice - All Plans | Midlands Choice - All Plans | $327 |
| Preferred Hlth Choices - All Plans | Preferred Hlth Choices - All Plan | $347 |
| Choicecare Comm - All Other Plans | Choicecare Comm - All Other Plans | $407 |
| Home State Hlth Mcaid | Home State Hlth Mcaid | $416 |
| Iowa Total Care Mcaid-All Plans | Iowa Total Care Mcaid-All Plans | $424 |
| Molina Mcaid-All Plans | Molina Mcaid-All Plans | $428 |
| Amerigroup Mcaid | Amerigroup Mcaid | $430 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.