Emergency visit, high (level 4) at Virginia Gay Hostpital. CPT 99284.
What Virginia Gay Hostpital publishes for this service, straight from its standard-charges file, last updated August 13, 2026.
Outpatient / ER
$9.19cash price (self-pay)
$547list price
$3.91–$5,195range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana PPO/POS/HMO-All Plans | Humana PPO/POS/HMO-All Plans | $70.00 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $71.22 |
| UHC Mcr Adv | UHC Mcr Adv | $110 |
| Va Ccn-All Plans | Va Ccn-All Plans | $110 |
| Health Alliance Mcr Adv | Health Alliance Mcr Adv | $112 |
| Medical Associates-All Plans | Medical Associates-All Plans | $176 |
| Health Alliance-All Other Plans | Health Alliance-All Other Plans | $192 |
| UHC-All Other Plans | UHC-All Other Plans | $204 |
| Wellmark HMO | Wellmark HMO | $227 |
| Wellmark PPO-All Other Plans | Wellmark PPO-All Other Plans | $227 |
| Cedar Valley Community Healthcare-All Plans | Cedar Valley Community H | $337 |
| Healthsmart-All Plans | Healthsmart-All Plans | $364 |
| Health Partners-All Plans | Health Partners-All Plans | $364 |
| Iowa Total Care Medicaid-All Plans | Iowa Total Care Medicaid-All Plan | $393 |
| Amerigroup Medicaid-All Plans | Amerigroup Medicaid-All Plans | $426 |
| Corvel-All Plans | Corvel-All Plans | $508 |
| Aetna/Coventry HMO-All Other Plans | Aetna/Coventry HMO-All Other Plan | $5,195 |
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