Emergency visit, high (level 4) at SBL Fayette County Hospital. CPT 99284.
What SBL Fayette County Hospital publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$741cash price (self-pay)
$741list price
$86.76–$1,601range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance Medicaid | Health Alliance Medicaid | $125 |
| Aetna Better Health | Aetna Better Health | $125 |
| Blue Cross Community Care-All Plans | Blue Cross Community Care-All Pl | $125 |
| Illinicare - All Plans | Illinicare - All Plans | $125 |
| Meridian-All Plans | Meridian-All Plans | $125 |
| Molina Medicaid-All Plans | Molina Medicaid-All Plans | $125 |
| Health Alliance Mcare | Health Alliance Mcare | $363 |
| Healthlink Mcr Adv | Healthlink Mcr Adv | $363 |
| Humana Choicecare - All Plans | Humana Choicecare - All Plans | $603 |
| Aetna Health Inc - All Other Plans | Aetna Health Inc - All Other Plan | $665 |
| Coventry/Ghp-All Plans | Coventry/Ghp-All Plans | $695 |
| Aetna Coventry | Aetna Coventry | $733 |
| Cigna - All Plans | Cigna - All Plans | $775 |
| BCBS Illinois - All Plans | BCBS Illinois - All Plans | $869 |
| Health Alliance - All Other Plans | Health Alliance - All Other Plans | $901 |
| Multiplan - All Plans | Multiplan - All Plans | $915 |
| Healthlink HMO | Healthlink HMO | $977 |
| Healthlink PPO - All Other Plans | Healthlink PPO - All Other Plans | $1,072 |
| United Healthcare - All Plans | United Healthcare - All Plans | $1,089 |
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