Emergency visit, high (level 4) at Springfield Memorial Hospital. CPT 99284.
What Springfield Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$1,904cash price (self-pay)
$1,904list price
$88.00–$3,289range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Magellan | Magellan PPO | $88.00 |
| BCBS Medicare Advantage | BCBS Medicare Advantage | $281 |
| Blue Cross Community MMAI/Dual Eligible | Blue Cross Community MMAI/Du | $409 |
| Aetna | Aetna Medicare Advantage | $440 |
| Health Alliance | Health Alliance ACA | $609 |
| Current Health Network PPO | Current Health Network PPO | $857 |
| Aetna | Aetna PPO | $872 |
| Health Alliance | Health Alliance MHS Employee Health Plan HMO | $876 |
| Commercial Workers Compensation | Commercial Workers Compensation | $962 |
| Health Alliance | Health Alliance Coordinated Care Plan (CCP) | $990 |
| Cigna | Cigna PPO | $1,000 |
| Illinois Workers Compensation | Illinois Workers Compensation | $1,013 |
| PHCS/MultiPlan | PHCS Savility PPO | $1,028 |
| HealthLink | HealthLink HMO | $1,085 |
| Health Alliance | Health Alliance Self Funded | $1,102 |
| 6 Degrees Health | 6 Degrees Health | $1,142 |
| Hst | Hst | $1,142 |
| HopeTrust | HopeTrust | $1,142 |
| Humana | Humana PPO | $1,142 |
| PHCS/MultiPlan | PHCS/MultiPlan PPO | $1,142 |
| HealthLink | HealthLink PPO | $1,200 |
| Consociate | Consociate PPO | $1,238 |
| Health Alliance | Health Alliance Gated PPO | $1,238 |
| HFN | HFN Platinum PPO | $1,238 |
| Hfn | Hfn PPO | $1,238 |
| Preferred Plan | Preferred Plan PPO | $1,428 |
| SOI McFarland | SOI McFarland PPO | $1,428 |
| SOI Rushville | SOI Rushville PPO | $1,428 |
| Coventry/Aetna | Coventry/Aetna First Health PPO | $1,447 |
| HealthLink | HealthLink EPO | $1,522 |
Inpatient
$1,904cash price (self-pay)
$1,904list price
$762–$1,904range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance | Health Alliance ACA | $762 |
| Health Alliance | Health Alliance MHS Employee Health Plan HMO | $876 |
| PHCS/MultiPlan | PHCS Savility PPO | $1,028 |
| Health Alliance | Health Alliance Gated PPO | $1,047 |
| Health Alliance | Health Alliance Self Funded | $1,102 |
| 6 Degrees Health | 6 Degrees Health | $1,142 |
| HopeTrust | HopeTrust | $1,142 |
| Hst | Hst | $1,142 |
| Humana | Humana PPO | $1,142 |
| Magellan | Magellan PPO | $1,142 |
| PHCS/MultiPlan | PHCS/MultiPlan PPO | $1,142 |
| HFN | HFN Platinum PPO | $1,238 |
| Hfn | Hfn PPO | $1,238 |
| Preferred Plan | Preferred Plan PPO | $1,428 |
| SOI McFarland | SOI McFarland PPO | $1,428 |
| SOI Rushville | SOI Rushville PPO | $1,428 |
| Methodist First Choice | Methodist First Choice PPO | $1,523 |
| Mutual Medical Plans | Mutual Medical Plans PPO | $1,618 |
| Blue Cross Blue Shield | BCBS HMO/PHAI | $1,904 |
| Blue Cross Blue Shield | BCBS PPO/Indemnity/ACA | $1,904 |
| BCBS | Blue Cross Memorial Health System | $1,904 |
| Liability | Liability | $1,904 |
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