Emergency visit, moderate (level 3) at Advocate Good Samaritan Hospital. CPT 99283.
What Advocate Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated November 4, 2025.
Outpatient / ER
$580cash price (self-pay)
$1,160list price
$419–$2,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ambetter | Medicare Advantage | $419 |
| Molina | Medicare Advantage | $419 |
| Oscar Health HMO | Medicare Advantage | $433 |
| Advocate Employee | Commercial | $457 |
| HSTechnology | Medicare Advantage | $554 |
| Cigna One Health | Commercial | $603 |
| Aetna | Commercial | $626 |
| Blue Cross Blue Shield City of Chicago | Commercial | $799 |
| Blue Cross Blue Shield Choice | Commercial | $864 |
| Blue Cross Blue Shield Blue Precision | Managed Care | $897 |
| Blue Cross Blue Shield | PPO | $910 |
| Blue Cross Blue Shield | HMO | $914 |
| Multiplan | Commercial | $928 |
| Private Healthcare Systems | Commercial | $928 |
| United Healthcare Charter | Commercial | $1,047 |
| United Healthcare Nexus | Commercial | $1,213 |
| United Healthcare Core Navigate | Commercial | $1,789 |
| Cigna | Commercial | $1,948 |
| United Healthcare | HMO | $2,071 |
Inpatient
$580cash price (self-pay)
$1,160list price
$507–$928range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Advocate Employee | Commercial | $507 |
| Private Healthcare Systems | Commercial | $719 |
| Multiplan | Commercial | $928 |
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