Emergency visit, high (level 4) at MercyOne Des Moines Medical Center. CPT 99284.
What MercyOne Des Moines Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$253cash price (self-pay)
$253list price
$9.09–$7,109range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | Molina Medicaid | $199 |
| Iowa Total Care | Iowa Total Care Medicaid | $394 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $395 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $395 |
| Medicare Medical Associates Health Plans | Medical Associates Medicare | $395 |
| Blue Cross - Ia (Wellmark) Medicare Advantage | Wellmark Medicare Adva | $399 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $403 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $411 |
| Blue Cross - Ky (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Ms | Wellmark PPO | $426 |
| Blue Cross - Mt | Wellmark PPO | $426 |
| Blue Cross - Me (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Md (Carefirst) | Wellmark PPO | $426 |
| Blue Benefit Administrators Of Massachusetts | Wellmark PPO | $426 |
| Blue Cross - Ia (Wellmark) | Wellmark HMO | $426 |
| Blue Cross - MA | Wellmark PPO | $426 |
| Blue Cross - Va (Carefirst) | Wellmark PPO | $426 |
| Blue Shield - Id (Regence) | Wellmark PPO | $426 |
| Blue Cross - Nh (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Nv (Anthem) | Wellmark PPO | $426 |
| Blue Cross - NY (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Nm | Wellmark PPO | $426 |
| Blue Cross - Nj (Horizon) | Wellmark PPO | $426 |
| Blue Shield - NY Highmark Western | Wellmark PPO | $426 |
| Blue Cross - NY (Excellus) | Wellmark PPO | $426 |
| Blue Cross - Nc | Wellmark PPO | $426 |
| Blue Shield - NY Highmark Northeastern | Wellmark PPO | $426 |
| Blue Cross - Ok | Wellmark PPO | $426 |
| Medical Associates | Medical Associates | $523 |
| Amish Hospital Aid | Amish Hospital Aid | $536 |
Inpatient
$284cash price (self-pay)
$284list price
$75.40–$284range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Intercommunity Health Ohp | Medicaid Iowa | $91.03 |
| Medicaid - NY | Medicaid Iowa | $91.03 |
| Medicaid - Nc | Medicaid Iowa | $91.03 |
| Medicaid - Nm | Medicaid Iowa | $91.03 |
| Medicaid - Nh | Medicaid Iowa | $91.03 |
| Medicaid - Nj | Medicaid Iowa | $91.03 |
| Medicaid - Nv | Medicaid Iowa | $91.03 |
| Medicaid - Mt | Medicaid Iowa | $91.03 |
| Buckeye Health Plan Medicaid Advantage | Medicaid Iowa | $91.03 |
| Care Wisconsin Medicaid | Medicaid Iowa | $91.03 |
| Partners Behavioral Lme | Medicaid Iowa | $91.03 |
| Vaya Health Lme | Medicaid Iowa | $91.03 |
| Cardinal Innovations Lme | Medicaid Iowa | $91.03 |
| Blue Cross - Sc Medicaid Advantage | Medicaid Iowa | $91.03 |
| Eastpointe Lme | Medicaid Iowa | $91.03 |
| Sunshine State Health Plan | Medicaid Iowa | $91.03 |
| Medicaid - Id | Medicaid | $94.78 |
| Rx Allwin | Medicare | $108 |
| Blue Cross - MA Medicare Advantage | Medicare | $108 |
| Blue Cross - FL Medicare Advantage | Medicare | $108 |
| Blue Cross - Ms Medicare Advantage | Medicare | $108 |
| Universal Medicare | Medicare | $108 |
| Nascentia Health Plus | Medicare | $108 |
| New Centry Health Careplus | Medicare | $108 |
| Carepartners Of Connecticut Medicare Advantage | Medicare | $108 |
| Evercare | Medicare | $108 |
| Health Choices | Wellmark BCBS | $198 |
| Wc California State Ins Fund | Workers Comp | $284 |
| Wc Am Trust N America | Workers Comp | $284 |
| Wc California State Comp Ins | Workers Comp | $284 |
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