Emergency visit, high (level 4) at MercyOne Dyersville Medical Center. CPT 99284.
What MercyOne Dyersville Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$185cash price (self-pay)
$253list price
$0.35–$1,441range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Iowa Dept Of Public Health | Care For Yourself | $284 |
| Iowa Total Care | Iowa Total Care Medicaid | $320 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $447 |
| Molina Medicaid | Molina Medicaid | $450 |
| Wellpoint Medicaid | Wellpoint Medicaid | $453 |
| Health Choices | Medical Associates | $484 |
| The Alliance | The Alliance | $505 |
| Aetna Domestic | Aetna | $647 |
| Aetna | Aetna | $647 |
| Meritain | Aetna | $647 |
| Multiplan | Multiplan | $704 |
| United Healthcare | United Healthcare | $704 |
| Geha | United Healthcare | $704 |
| Blue Cross - Ia (Wellmark) Medicare Advantage | Wellmark Medicare Adva | $710 |
| Health Partners Medicare Advantage | Unitypoint Health Partners Medica | $724 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $745 |
| Medicare Medical Associates Health Plans | Medical Associates Medicare | $790 |
| Claimdoc | Claimdoc | $880 |
| United Healthcare | United Healthcare Deere Premier | $896 |
| Amish Hospital Aid | Amish Hospital Aid | $953 |
| Aetna Eap | Aetna | $1,059 |
| 1199 National Benefit Fund | Aetna | $1,059 |
| First Health | Aetna | $1,059 |
| Luminare Health | Aetna | $1,059 |
| Asr Health Benefits | Aetna | $1,059 |
| Coventry | Aetna | $1,059 |
| Allied Benefit Systems | Aetna | $1,059 |
| Webtpa | Aetna | $1,059 |
| Medical Mutual | Aetna | $1,059 |
| Christian Brother Services | Aetna | $1,059 |
Inpatient
$284cash price (self-pay)
$284list price
$75.40–$284range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcccp-Michigan | Medicaid Iowa | $77.37 |
| Vnsny Choice Medicaid | Medicaid Iowa | $77.37 |
| Mvp Medicaid Advantage | Medicaid Iowa | $77.37 |
| Priority Health Medicaid | Medicaid Iowa | $77.37 |
| Blue Cross Complete - Mi | Medicaid Iowa | $77.37 |
| Cmh Wayne County/Carelink | Medicaid Iowa | $77.37 |
| Cmh West Mi County | Medicaid Iowa | $77.37 |
| Care Connections Of Northern Iowa | Medicaid Iowa | $77.37 |
| Health Plus Phsp Medicaid Adv | Medicaid Iowa | $77.37 |
| Upmc Medicaid Advantage | Medicaid Iowa | $77.37 |
| Trillium Community Ohp | Medicaid Iowa | $77.37 |
| Pacificsource Health Plans Medicaid Advantage | Medicaid Iowa | $77.37 |
| Green Mountain Medicaid Advantage | Medicaid Iowa | $77.37 |
| Blue Cross - Nj (Horizon) Medicaid Advantage | Medicaid Iowa | $77.37 |
| Rx Allwin | Medicare | $91.56 |
| Blue Cross - Id Medicare Advantage | Medicare | $91.56 |
| Blue Care Network Advantage | Medicare | $91.56 |
| Phoenix Medicare Advantage | Medicare | $91.56 |
| Blue Cross - Wi (Anthem) Medicare Advantage | Medicare | $91.56 |
| Blue Cross - IL Medicare Advantage | Medicare | $91.56 |
| Blue Cross - Mn Medicare Advantage | Medicare | $91.56 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $91.56 |
| Medicare | Medicare | $91.56 |
| Blue Care Network | Wellmark BCBS | $169 |
| Blue Cross - Ut (Regence) | Wellmark BCBS | $169 |
| Blue Cross - TX | Wellmark BCBS | $169 |
| Blue Cross - Sc | Wellmark BCBS | $169 |
| Blue Cross - Tn | Wellmark BCBS | $169 |
| Blue Cross - Ri | Wellmark BCBS | $169 |
| Blue Shield - Pa (Highmark) | Wellmark BCBS | $169 |
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