Emergency visit, high (level 4) at Saint Alphonsus Regional Medical Center. CPT 99284.
What Saint Alphonsus Regional 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
$5.51–$21,789range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medigold Medicare Advantage | Medigold Medicare Advantage | $442 |
| Molina Medicare Advantage | Molina Medicare Advantage | $455 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $455 |
| American Health Advantage Of Idaho | American Health Medicare Advantag | $459 |
| Pacificsource Health Plans Medicare Advantage | Pacificsource Medicare | $464 |
| Moda Health | Moda Health Select | $875 |
| Molina Marketplace | Molina Marketplace | $1,063 |
| Blue Cross - Id | Blue Cross Of Idaho Connected Care | $1,083 |
| Webtpa | Pacific Steel | $1,189 |
| Blue Cross - Id | Bci HMO | $1,204 |
| Blue Cross - Ga (Anthem) | Bci HMO | $1,204 |
| Blue Cross - Ut (Regence) | Bci HMO | $1,204 |
| Blue Cross - Wa (Premera) | Bci HMO | $1,204 |
| Blue Cross - Hi | Bci HMO | $1,204 |
| Pacificsource Health Plans | Pacificsource Smart Alliance | $1,214 |
| Blue Shield - Id (Regence) | Regence Bs PPO 2 | $1,255 |
| Pacificsource Health Plans | Pacificsource | $1,477 |
| Allegiance | Woodgrain Millwork | $1,497 |
| Webtpa | First Choice Health | $1,720 |
| First Choice Health | First Choice Health | $1,720 |
| Providence | First Choice Health | $1,720 |
| Humana | Humana | $1,780 |
| Family Life Insurance Company | Multiplan | $1,821 |
| Christian Care Ministry | Multiplan | $1,821 |
| Dean Health | Multiplan | $1,821 |
| Geha | United Healthcare | $1,821 |
| Phcs | Multiplan | $1,821 |
| Allied National Global Care | Multiplan | $1,821 |
| Paramount HMO | Multiplan | $1,821 |
| Ghc Scw | Multiplan | $1,821 |
Inpatient
$267cash price (self-pay)
$267list price
$75.40–$267range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Medicaid | Medicaid | $94.78 |
| Ucare Medicaid | Medicaid | $94.78 |
| Rx Allwin | Medicare | $109 |
| Medicare Alternate Payor | Medicare | $109 |
| Perennial Advantage | Medicare | $109 |
| Champion Health Plan Mcr Advantage | Medicare | $109 |
| Prominence Medicare | Medicare | $109 |
| Anthem Mycare Ohio | Medicare | $109 |
| Aetna Medicare Assure Premier HMO D-Snp | Medicare | $109 |
| Central Health Medicare Advantage | Medicare | $109 |
| Champva | Tricare | $110 |
| Tricare | Tricare | $110 |
| Blue Cross - Oh (Anthem) | Blue Cross | $244 |
| Blue Cross - Az | Blue Cross | $244 |
| Blue Cross - Ak (Premera) | Blue Cross | $244 |
| Blue Cross - Ms | Blue Cross | $244 |
| Blue Cross - MA | Blue Cross | $244 |
| Blue Cross - Nh (Anthem) | Blue Cross | $244 |
| Blue Cross - Nv (Anthem) | Blue Cross | $244 |
| Blue Cross - NY (Anthem) | Blue Cross | $244 |
| Blue Cross - Nm | Blue Cross | $244 |
| Blue Cross - Nj (Horizon) | Blue Cross | $244 |
| Blue Shield - NY Highmark Western | Blue Cross | $244 |
| Blue Cross - NY (Excellus) | Blue Cross | $244 |
| Blue Cross - Nc | Blue Cross | $244 |
| Health Choices | Blue Cross | $244 |
| Wc Hartford | Workers Comp | $247 |
| Wc Aims | Workers Comp | $247 |
| Wc Advantage | Workers Comp | $247 |
| East Greenbush Central School District | Workers Comp | $247 |
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All common services at Saint Alphonsus Regional Medical Center