Emergency visit, high (level 4) at MercyOne North Iowa Medical Center. CPT 99284.
What MercyOne North Iowa 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–$5,594range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Iowa Total Care | Iowa Total Care Medicaid | $202 |
| Molina Medicaid | Molina Medicaid | $408 |
| Blue Cross - TX | Wellmark PPO | $426 |
| Blue Cross - Tn | Wellmark PPO | $426 |
| Blue Cross - Sc | Wellmark PPO | $426 |
| Blue Cross - Wv (Highmark) | Wellmark PPO | $426 |
| Blue Cross - MA | Wellmark PPO | $426 |
| Blue Cross - Md (Carefirst) | Wellmark PPO | $426 |
| Blue Cross - Me (Anthem) | Wellmark PPO | $426 |
| Blue Cross - La | Wellmark PPO | $426 |
| Blue Cross - Ky (Anthem) | Wellmark PPO | $426 |
| Blue Distinction Transplant | Wellmark PPO | $426 |
| Blue Cross - Nm | Wellmark PPO | $426 |
| Blue Cross - Nj (Horizon) | Wellmark PPO | $426 |
| Blue Cross - Nh (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Nv (Anthem) | Wellmark PPO | $426 |
| Pre-Employment | Wellmark PPO | $426 |
| Wc Domestic | Wellmark PPO | $426 |
| Blue Benefit Administrators Of Massachusetts | Wellmark PPO | $426 |
| Blue Cross - Mt | Wellmark PPO | $426 |
| Blue Cross - Ms | Wellmark PPO | $426 |
| Blue Shield - NY Highmark Northeastern | Wellmark PPO | $426 |
| Blue Shield - NY Highmark Western | Wellmark PPO | $426 |
| Blue Cross - Ia (Wellmark) | Wellmark PPO | $426 |
| Blue Cross - Ia (Wellmark) | Wellmark HMO | $426 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $441 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $441 |
| Blue Cross - Ia (Wellmark) Medicare Advantage | Wellmark Medicare Adva | $445 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $450 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $459 |
Inpatient
$284cash price (self-pay)
$284list price
$76.68–$284range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Dph Tb Program | Medicaid Iowa | $91.03 |
| Maryland Breast & Cervical Program | Medicaid Iowa | $91.03 |
| Pace Of Southwest Michigan | Medicaid Iowa | $91.03 |
| Oregon Screenwise | Medicaid Iowa | $91.03 |
| Medicaid - Wy | Medicaid Iowa | $91.03 |
| Childrens Comm Health Plan | Medicaid Iowa | $91.03 |
| Blue Cross - In (Anthem) Medicaid Advantage | Medicaid Iowa | $91.03 |
| Medicaid MA Qmb | Medicaid Iowa | $91.03 |
| Keystone First Chip | Medicaid Iowa | $91.03 |
| Medicaid - NY Ssl | Medicaid Iowa | $91.03 |
| Screening For Life | Medicaid Iowa | $91.03 |
| Community Care Medicaid | Medicaid Iowa | $91.03 |
| Cmh Barry County | Medicaid Iowa | $91.03 |
| Cmh Bay-Arenac County | Medicaid Iowa | $91.03 |
| Cmh Berrien County | Medicaid Iowa | $91.03 |
| Cmh Livingston County | Medicaid Iowa | $91.03 |
| Cmh Ionia County | Medicaid Iowa | $91.03 |
| Cmh Genesee County | Medicaid Iowa | $91.03 |
| Rx Allwin | Medicare | $108 |
| Triwest Health Alliance | Tricare | $110 |
| Nebraska Total Care | Nebraska Total Care Medicaid | $114 |
| Amps | Amps | $148 |
| Blue Cross - IL | Wellmark BCBS | $198 |
| Usa Managed Care | Usa Managed Care | $213 |
| Quiktrip | Quiktrip | $214 |
| Health Choices | Midlands Choice | $226 |
| Auxiant | Midlands Choice | $226 |
| Claimdoc | Claimdoc | $230 |
| Centivo | Centivo | $245 |
| Velocity | Velocity | $258 |
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