Emergency visit, high (level 4) at Adams Memorial Hospital. CPT 99284.
What Adams Memorial Hospital publishes for this service, straight from its standard-charges file, last updated August 14, 2026.
Outpatient / ER
$638cash price (self-pay)
$638list price
$50.27–$1,980range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna - All Other Plans | Aetna - All Other Plans | $86.54 |
| First Health - All Plans | First Health - All Plans | $86.54 |
| Cigna - All Plans | Cigna - All Plans | $97.12 |
| UHC Mcr Adv | UHC Mcr Adv | $103 |
| Buckeye Mcaid | Buckeye Mcaid | $110 |
| Caresource Hoosier | Caresource Hoosier | $110 |
| Humana Choicecare Mcaid | Humana Choicecare Mcaid | $110 |
| Amerihealth Caritas Medicaid - All Plans | Amerihealth Caritas Medicai | $110 |
| Caresource Oh Mcaid | Caresource Oh Mcaid | $110 |
| Mdwise Mcaid | Mdwise Mcaid | $110 |
| Mhs Hoosier | Mhs Hoosier | $110 |
| Paramount Mcaid | Paramount Mcaid | $110 |
| Anthem Hlthy In | Anthem Hlthy In | $111 |
| Caresource Oh Mcare | Caresource Oh Mcare | $111 |
| Mdwise Hip | Mdwise Hip | $111 |
| Mdwise Mcr Adv | Mdwise Mcr Adv | $111 |
| Mhs Mcare | Mhs Mcare | $111 |
| Va Ccn - All Plans | Va Ccn - All Plans | $111 |
| Anthem Mcr Adv | Anthem Mcr Adv | $111 |
| Buckeye Mcare - All Other Plans | Buckeye Mcare - All Other Plans | $111 |
| Caresource Hlthy In | Caresource Hlthy In | $111 |
| Caresource Oh Marketplace | Caresource Oh Marketplace | $111 |
| Encore PPO - All Plans | Encore PPO - All Plans | $111 |
| Mhs Hlthy In | Mhs Hlthy In | $111 |
| Aetna Mcr Adv | Aetna Mcr Adv | $113 |
| Humana Choicecare - All Other Plans | Humana Choicecare - All Other Pl | $117 |
| Humana Choicecare Mcr PPO | Humana Choicecare Mcr PPO | $117 |
| Paramount Comm - All Other Plans | Paramount Comm - All Other Plans | $120 |
| Php Freedom/Options - All Other Plans | Php Freedom/Options - All Othe | $121 |
| Caresource Mcr Adv | Caresource Mcr Adv | $122 |
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