Emergency visit, high (level 4) at St. Luke's Jerome Standard Charges. CPT 99284.
What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$1,851cash price (self-pay)
$1,851list price
$466–$1,758range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial [1028] | Hb Mv Va Ccn | $466 |
| Medicare Advantage Generic [1019] | Hb Mv Medicare Advantage | $466 |
| Blue Cross/Medicare Advantage [1009] | Hb Mv Bci True & Secure Med Adv | $471 |
| Medicare Advantage Aetna [1017] | Hb Mv Aetna Med Adv | $512 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $694 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $694 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $694 |
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $897 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $1,099 |
| Commercial [1028] | Hb Mv Slhp Select Health | $1,099 |
| Blue Cross Out Of State [1041] | Hb Mv Bci Out Of State | $1,342 |
| Blue Shield Alt [100401] | Hb Mv Regence Out Of State | $1,342 |
| Commercial [1028] | Hb Mv Regence PPO & Traditional | $1,342 |
| Commercial [1028] | Hb Mv H2b | $1,388 |
| H2b [1068] | Hb Mv H2b | $1,388 |
| Pacificsource [1020] | Hb Mv Pacificsource PPO Voyager | $1,388 |
| Aetna [1021] | Hb Mv Bp Aetna | $1,481 |
| Cigna [1062] | Hb Mv Cigna | $1,481 |
| Commercial [1028] | Hb Mv Bp Aetna | $1,481 |
| Commercial [1028] | Hb Mv Cigna | $1,481 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $1,481 |
| Providence [1022] | Hb Mv Cigna | $1,481 |
| Webtpa [1071] | Hb Mv Bp Aetna | $1,481 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $1,490 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $1,490 |
| Commercial [1028] | Hb Mv Amps | $1,573 |
| Commercial [1028] | Hb Mv Christian Health Aid | $1,573 |
| Commercial [1028] | Hb Mv First Choice Health | $1,573 |
| First Health [1064] | Hb Mv First Choice Health | $1,573 |
| Webtpa [1071] | Hb Mv First Choice Health | $1,573 |
Inpatient
$1,851cash price (self-pay)
$1,851list price
$1,203–$1,583range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $1,203 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $1,203 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $1,203 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $1,203 |
| Commercial [1028] | Hb Mv Slhp Select Health | $1,203 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $1,203 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $1,203 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $1,203 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $1,203 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $1,203 |
| Select Health [1063] | Hb Mv Slhp Select Health | $1,203 |
| Select Health [1063] | Hb Mv Slhp Select Health Qhp | $1,203 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Large Gr | $1,203 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Qhp | $1,203 |
| Commercial [1028] | Hb Mv Va Ccn | $1,481 |
| Veterans Affairs [1056] | Hb Mv Va Ccn | $1,481 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $1,583 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $1,583 |
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