Emergency visit, moderate (level 3) at Jacksonville Memorial Hospital. CPT 99283.
What Jacksonville Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$1,300cash price (self-pay)
$1,337list price
$1.78–$2,546range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield | Blue Cross Community MMAI/Dual Eligible | $129 |
| Coventry | Coventry Advantra Medicare Advantage HMO | $138 |
| Health Alliance | Health Alliance Medicare Advantage | $138 |
| Humana | Humana/ChoiceCare Medicare Advantage PPO/HMO | $138 |
| Medicare | Medicare | $138 |
| United HealthCare | United HealthCare Medicare Advantage | $145 |
| Tricare | Tricare | $153 |
| WellCare Medicare Advantage PPO | WellCare Medicare Advantage PPO | $211 |
| UHC Va Ccn | UHC Va Ccn | $214 |
| Commercial Workers Compensation | Commercial Workers Compensation | $329 |
| Illinois Workers Compensation | Illinois Workers Compensation | $435 |
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $615 |
| Corvel/CorCare | Corvel/CorCare | $720 |
| 6 Degrees Health | 6 Degrees Health | $802 |
| Hope Trust | Hope Trust | $802 |
| Hst | Hst | $802 |
| Health Alliance | Health Alliance Fully Insured/Self Funded/ACA | $889 |
| Cigna | Cigna | $927 |
| Aetna | Aetna PPO | $1,000 |
| Current Health Network | Current Health Network | $1,003 |
| Healthlink | Healthlink HMO | $1,102 |
| Humana/ChoiceCare | Humana/ChoiceCare | $1,140 |
| PHCS/Multiplan | PHCS/Multiplan PPO | $1,203 |
| Hfn | Hfn PPO | $1,270 |
| HFN | HFN Workers Compensation | $1,270 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $1,337 |
| Liability | Liability | $1,337 |
| Medicaid | Illinois Medicaid | $1,337 |
| Molina HealthCare | Molina Medicaid | $1,337 |
| United Healthcare | United Healthcare PPO | $1,768 |
Inpatient
$1,300cash price (self-pay)
$1,337list price
$598–$1,374range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $615 |
| Current Health Network | Current Health Network | $735 |
| 6 Degrees Health | 6 Degrees Health | $802 |
| Hope Trust | Hope Trust | $802 |
| Hst | Hst | $802 |
| Cigna | Cigna | $927 |
| Aetna | Aetna PPO | $935 |
| Humana/ChoiceCare | Humana/ChoiceCare | $1,140 |
| Hfn | Hfn PPO | $1,270 |
| HFN | HFN Workers Compensation | $1,270 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $1,337 |
| Liability | Liability | $1,337 |
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