Emergency visit, high (level 4) at St. Luke's Boise Standard Charges. CPT 99284.
What St. Luke's Boise Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$1,851cash price (self-pay)
$2,314list price
$451–$3,332range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial [1028] | Hb Tv Va Ccn | $451 |
| Medicare Advantage Generic [1019] | Hb Tv Medicare Advantage | $451 |
| Blue Cross/Medicare Advantage [1009] | Hb Tv Bci True & Secure Med Adv | $455 |
| Medicare Advantage Generic [1019] | Hb Tv Molina Med Adv | $460 |
| Medicare Advantage Aetna [1017] | Hb Tv Aetna Med Adv | $496 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Carepoint Qhp | $868 |
| Commercial [1028] | Hb Tv Slhp Mountain Health Coop | $868 |
| Commercial [1028] | Hb Tv Slhp Select Health Qhp | $868 |
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Tv Slhp St Lukes | $1,236 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Large Group | $1,374 |
| Commercial [1028] | Hb Tv Slhp Select Health | $1,374 |
| Blue Cross Federal [1008] | Hb Tv Bci PPO Fep | $1,490 |
| Blue Cross Idaho [1007] | Hb Tv Bci PPO Fep | $1,490 |
| Blue Cross Out Of State [1041] | Hb Tv Bci Out Of State | $1,677 |
| Blue Shield Alt [100401] | Hb Tv Regence Out Of State | $1,677 |
| Commercial [1028] | Hb Tv Regence PPO & Traditional | $1,677 |
| Commercial [1028] | Hb Tv H2b | $1,735 |
| H2b [1068] | Hb Tv H2b | $1,735 |
| Aetna [1021] | Hb Tv Bp Aetna | $1,851 |
| Cigna [1062] | Hb Tv Cigna | $1,851 |
| Commercial [1028] | Hb Tv Bp Aetna | $1,851 |
| Commercial [1028] | Hb Tv Cigna | $1,851 |
| Commercial [1028] | Hb Tv Multiplan Primary Network | $1,851 |
| Providence [1022] | Hb Tv Cigna | $1,851 |
| Webtpa [1071] | Hb Tv Bp Aetna | $1,851 |
| Commercial [1028] | Hb Tv United Healthcare | $1,897 |
| Geha [1065] | Hb Tv United Healthcare | $1,897 |
| United Healthcare [1025] | Hb Tv United Healthcare | $1,897 |
| United Medical Resources [1051] | Hb Tv United Healthcare | $1,897 |
| Commercial [1028] | Hb Tv Ccn First Health | $1,909 |
Inpatient
$1,851cash price (self-pay)
$2,314list price
$1,203–$3,165range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Tv Slhp St Lukes | $1,504 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Carepoint Qhp | $1,504 |
| Blue Cross Idaho [1007] | Hb Tv Slhp Blue Cross Large Group | $1,504 |
| Commercial [1028] | Hb Tv Slhp Mountain Health Coop | $1,504 |
| Commercial [1028] | Hb Tv Slhp Select Health | $1,504 |
| Commercial [1028] | Hb Tv Slhp Select Health Qhp | $1,504 |
| Medicare Advantage Pacificsource [1039] | Hb Tv Slhp Pacificsource Med | $1,504 |
| Mountain Health Co-Op [1067] | Hb Tv Slhp Mountain Health Coop | $1,504 |
| Pacificsource [1020] | Hb Tv Pacificsource Navigator Large Group | $1,504 |
| Pacificsource [1020] | Hb Tv Slhp Pacificsource Navigator Qhp | $1,504 |
| Select Health [1063] | Hb Tv Slhp Select Health | $1,504 |
| Select Health [1063] | Hb Tv Slhp Select Health Qhp | $1,504 |
| St Lukes Health Plan [1046] | Hb Tv Slhp St Lukes Health Plan Large Gr | $1,504 |
| St Lukes Health Plan [1046] | Hb Tv Slhp St Lukes Health Plan Qhp | $1,504 |
| Commercial [1028] | Hb Tv Va Ccn | $1,851 |
| Veterans Affairs [1056] | Hb Tv Va Ccn | $1,851 |
| Blue Cross Federal [1008] | Hb Tv Bci PPO Fep | $1,978 |
| Blue Cross Idaho [1007] | Hb Tv Bci PPO Fep | $1,978 |
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