Emergency visit, high (level 4) at MercyOne West Des Moines Medical Center. CPT 99284.
What MercyOne West 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–$5,328range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Iowa Total Care | Iowa Total Care Medicaid | $197 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $395 |
| Molina Medicaid | Molina Medicaid | $398 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $411 |
| Blue Shield - Wa (Regence) | Wellmark PPO | $426 |
| Blue Cross - Wv (Highmark) | Wellmark PPO | $426 |
| Blue Cross - Wy | Wellmark PPO | $426 |
| Blue Cross - Vt | Wellmark PPO | $426 |
| Blue Cross - Va (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Va (Carefirst) | Wellmark PPO | $426 |
| Blue Cross - Wa (Premera) | Wellmark PPO | $426 |
| Blue Cross - Mn | Wellmark PPO | $426 |
| Blue Cross - Al | Wellmark PPO | $426 |
| Blue Shield - Id (Regence) | Wellmark PPO | $426 |
| Blue Cross - Mo (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Nd | Wellmark PPO | $426 |
| Blue Cross - Ne | Wellmark PPO | $426 |
| Blue Cross - Mi | Wellmark PPO | $426 |
| Blue Cross - In (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Ks | Wellmark PPO | $426 |
| Blue Cross - Dc (Carefirst) | Wellmark PPO | $426 |
| Blue Cross - FL | Wellmark PPO | $426 |
| Blue Cross - Ga (Anthem) | Wellmark PPO | $426 |
| Blue Shield - CA | Wellmark PPO | $426 |
| Blue Cross - Co (Anthem) | Wellmark PPO | $426 |
| Blue Cross - Ct (Anthem) | Wellmark PPO | $426 |
| Blue Cross - De (Highmark) | Wellmark PPO | $426 |
| Amish Hospital Aid | Amish Hospital Aid | $536 |
| Oscar | Oscar | $573 |
| Medical Associates | Medical Associates | $573 |
Inpatient
$284cash price (self-pay)
$284list price
$75.40–$284range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Meridian Rx | Medicaid Iowa | $91.03 |
| Rx 340b Pass Along | Medicaid Iowa | $91.03 |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | Medicaid Iowa | $91.03 |
| Medicaid - Ct | Medicaid Iowa | $91.03 |
| Medicaid - Co | Medicaid Iowa | $91.03 |
| Medicaid - Ga | Medicaid Iowa | $91.03 |
| Medicaid - De | Medicaid Iowa | $91.03 |
| Medicaid - Dc | Medicaid Iowa | $91.03 |
| Medicaid - FL | Medicaid Iowa | $91.03 |
| Medicaid - Az | Medicaid Iowa | $91.03 |
| Medicaid - Al | Medicaid Iowa | $91.03 |
| Philadelphia County Funding | Medicaid Iowa | $91.03 |
| Rx Allwin | Medicare | $108 |
| Rx Grane Grnmedd | Medicare | $108 |
| Welbe Health | Medicare | $108 |
| Jefferson Health Plans Medicare | Medicare | $108 |
| Gateway Health Plan | Medicare | $108 |
| Alignment Health Plan Medicare Advantage | Medicare | $108 |
| Provider Partners Health Plan Of Indiana | Medicare | $108 |
| Veterans Eval Services | Tricare | $110 |
| Triwest Health Alliance | Tricare | $110 |
| Optum Health | Ubh Optum | $115 |
| Avera | Avera Health Plan | $166 |
| Ambetter | Ambetter | $187 |
| Blue Cross - Wy | Wellmark BCBS | $198 |
| BCBS Generic | Wellmark BCBS | $198 |
| Blue Distinction Transplant | Wellmark BCBS | $198 |
| Blue Benefit Administrators Of Massachusetts | Wellmark BCBS | $198 |
| Blue Cross - Vt | Wellmark BCBS | $198 |
| Kaiser Domestic | Wellmark BCBS | $198 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at MercyOne West Des Moines Medical Center