Emergency visit, high (level 4) at West Suburban Medical Center. CPT 99284.
What West Suburban Medical Center publishes for this service, straight from its standard-charges file, last updated March 17, 2025.
Outpatient / ER
$723cash price (self-pay)
$2,127list price
$163–$2,760range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | PPO | $163 |
| Blue Cross | HMO | $316 |
| Blue Cross | Precision HMO | $354 |
| Blue Cross | Blue Advantage MMAI | $431 |
| Humana | MMAI | $431 |
| Aetna | Medicare Advantage HMO/PPO | $444 |
| Ambetter | Marketplace | $444 |
| Blue Cross | Medicare Advantage | $444 |
| Cigna Healthspring | Medicare Advantage | $444 |
| Humana | Medicare Advantage Gold Plan | $444 |
| Longevity | Medicare Advantage | $444 |
| Wellcare | Medicare Advantage | $444 |
| Zing | Medicare Advantage | $444 |
| Oscar | Medicare Advantage | $453 |
| Cigna | All Commercial Plans | $510 |
| NALC | All Commercial Plans | $510 |
| Aetna | EPO/HMO/POS/PPO/Choice/NAP | $787 |
| Aetna Rental Network | All Plans | $1,382 |
| United Healthcare | Navigate | $2,595 |
| Golden Rule | All Commercial Plans | $2,760 |
| United Healthcare | All Other Commercial Plans | $2,760 |
Inpatient
$723cash price (self-pay)
$2,127list price
$1,382–$1,382range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Rental Network | All Plans | $1,382 |
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