Emergency visit, high (level 4) at Mountain View Hospital. CPT 99284.
What Mountain View Hospital publishes for this service, straight from its standard-charges file, last updated March 16, 2026.
Outpatient / ER
$1,912cash price (self-pay)
$1,912list price
$390–$923range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | ChoiceCare Medicare Advantage | $390 |
| Aetna | Medicare Advantage | $410 |
| Anasazi Medical Payment Solutions | Medicare Adv. | $410 |
| Blue Cross of ID | Medicare Advantage | $410 |
| Molina | Medicare Advantage and Dual Eligible | $410 |
| Mount Carmel Health Plan | Medicare Advantage | $410 |
| Optum Care Network ID | Medicare Advantage | $410 |
| PacificSource | Medicare Advantage | $410 |
| SelectHealth | Medicare Advantage | $410 |
| United Healthcare | Medicare Advantage | $410 |
| Blue Cross of ID | Commercial (Trad, PPO, POS) | $456 |
| Blue Cross of ID - OON | Emergency Only | $456 |
| Moda | Select/Connexus | $923 |
| Molina | Marketplace | $923 |
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