Emergency visit, high (level 4) at MercyOne Clinton Medical Center. CPT 99284.
What MercyOne Clinton Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$9.09–$1,558range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Allwin | Medicare | $62.47 |
| Medical Associates | Medical Associates | $312 |
| Iowa Total Care | Iowa Total Care Medicaid | $384 |
| Molina Medicaid | Molina Medicaid | $388 |
| Blue Cross - Nm | Wellmark PPO | $426 |
| Blue Cross - NY (Excellus) | Wellmark PPO | $426 |
| Blue Cross - Pa (Capital) | Wellmark PPO | $426 |
| Blue Cross - Ri | Wellmark PPO | $426 |
| Blue Shield - Pa (Highmark) | Wellmark PPO | $426 |
| Blue Cross - Tn | Wellmark PPO | $426 |
| Blue Cross - Sc | Wellmark PPO | $426 |
| Blue Cross - TX | Wellmark PPO | $426 |
| Blue Cross - Vt | Wellmark PPO | $426 |
| Blue Cross - Ar | Wellmark PPO | $426 |
| Blue Cross - Ne | Wellmark PPO | $426 |
| Blue Cross - Ak (Premera) | Wellmark PPO | $426 |
| Blue Cross - Az | Wellmark PPO | $426 |
| Blue Cross - Oh (Anthem) | Wellmark PPO | $426 |
| Blue Cross - CA (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Sd (Wellmark) | Wellmark PPO | $426 |
| Blue Cross - FL | Wellmark PPO | $426 |
| Blue Shield - CA | Wellmark PPO | $426 |
| Blue Cross - Ga (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Dc (Carefirst) | Wellmark PPO | $426 |
| Blue Cross - Hi | Wellmark PPO | $426 |
| Blue Shield - Id (Regence) | Wellmark PPO | $426 |
| Blue Cross - Ut (Regence) | Wellmark PPO | $426 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $435 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $435 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $453 |
Inpatient
$284cash price (self-pay)
$284list price
$75.40–$284range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Id County Cat Fund | Medicaid Iowa | $91.03 |
| Id County Payette | Medicaid Iowa | $91.03 |
| Id County Other | Medicaid Iowa | $91.03 |
| County Funding Generic | Medicaid Iowa | $91.03 |
| Cmh North Country | Medicaid Iowa | $91.03 |
| Medicaid Spenddown | Medicaid Iowa | $91.03 |
| Broward County Dept Of Health | Medicaid Iowa | $91.03 |
| New York Cancer Services Program | Medicaid Iowa | $91.03 |
| Fresno County Ccs | Medicaid Iowa | $91.03 |
| Health Safety Net | Medicaid Iowa | $91.03 |
| Idaho Womens Health Check | Medicaid Iowa | $91.03 |
| Medicaid - Mn | Medicaid Iowa | $91.03 |
| Medicaid - Ms | Medicaid Iowa | $91.03 |
| Medicaid - Mo | Medicaid Iowa | $91.03 |
| Rx Allwin | Medicare | $108 |
| Pace Cny | Medicare | $108 |
| Buckeye Health Plan Medicare Advantage | Medicare | $108 |
| Solis Health Plans | Medicare | $108 |
| Mass General Brigham Mcr Adv | Medicare | $108 |
| New Centry Health Careplus | Medicare | $108 |
| Carepartners Of Connecticut Medicare Advantage | Medicare | $108 |
| Perennial Advantage | Medicare | $108 |
| Scan Health Plan Mcr Ipa Meritage Oon | Medicare | $108 |
| Highmark Health Options Dual Plan | Medicare | $108 |
| Prominence Medicare | Medicare | $108 |
| Champion Health Plan Mcr Advantage | Medicare | $108 |
| Prime Health Services Medicare Advantage | Medicare | $108 |
| Medicare Medical Associates Health Plans | Medicare | $108 |
| Champva | Tricare | $110 |
| Iowa Health Advantage | Iowa Heath Advantage | $113 |
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