Emergency visit, high (level 4) at Gottlieb Memorial Hospital. CPT 99284.
What Gottlieb Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$646cash price (self-pay)
$3,400list price
$413–$3,545range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS IL | MMP/Duals | $413 |
| Aetna | Medicare Advantage | $444 |
| VACCN United | Veterans Affairs | $444 |
| Humana | Medicare Advantage | $454 |
| Cigna | Medicare Advantage | $457 |
| Centene | Medicare Advantage | $466 |
| Molina | Medicare Advantage | $466 |
| Wellcare | Medicare Advantage | $466 |
| Oscar IFP | Health Exchange | $488 |
| Meridian | MMP/Duals | $515 |
| Molina Marketplace IFP | Health Exchange | $555 |
| Cigna | HMO | $823 |
| Aetna | All Products | $1,496 |
| BCBS IL | Blue Choice | $1,571 |
| Cigna | PPO | $1,846 |
| BCBS IL | PPO | $1,955 |
| UHC | Navigate Core | $2,102 |
| UHC | All Products | $2,152 |
| BCBS IL | HMO | $2,278 |
| BCBS IL | Blue Precision | $2,366 |
| Aetna | FH-Medical Rental | $2,482 |
| Meridian | Medicaid | $3,400 |
| Molina | Medicaid | $3,400 |
| Humana | All Products | $3,545 |
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