Emergency visit, high (level 4) at Community Hospital of Bremen. CPT 99284.
What Community Hospital of Bremen publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$839cash price (self-pay)
$1,291list price
$400–$1,678range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $400 |
| Anthem | Exchange | $400 |
| Anthem | Medicare Advantage | $400 |
| Anthem | Workers Compensation | $400 |
| Caresource | Exchange | $400 |
| Humana | Medicare Advantage | $400 |
| MHS | Exchange | $400 |
| UHC | Medicare Advantage | $400 |
| VA Optum | VA | $400 |
| Anthem | Pathway Essentials | $516 |
| Plain Church | Commercial | $516 |
| Immergrun | Commercial | $646 |
| Anthem | Commercial PPO | $707 |
| Anthem | Commercial Trad | $777 |
| Cigna Sagamore | Commercial | $897 |
| Cigna Sagamore | PPO | $897 |
| CHA | Employer Group 4 | $904 |
| Medishare Multiplan | Commercial | $968 |
| PHP | Commercial | $968 |
| Priority Health | Commercial | $968 |
| Aetna | Commercial | $976 |
| Allied Benefit | Commercial | $976 |
| CHA | Commercial | $994 |
| UHC | Commercial | $1,020 |
| Multiplan | Commercial | $1,033 |
| All Savers | Commercial | $1,059 |
| Cigna Prof Benefit | Commercial | $1,059 |
| UMR UHC | Medicare Advantage | $1,059 |
| Caresource | IN Medicaid HIP | $1,678 |
Inpatient
$839cash price (self-pay)
$1,291list price
$646–$1,678range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Immergrun | Commercial | $646 |
| Anthem | Commercial PPO | $686 |
| Anthem | Commercial Trad | $778 |
| Cigna Sagamore | Commercial | $897 |
| Cigna Sagamore | PPO | $897 |
| CHA | Employer Group 4 | $904 |
| Medishare Multiplan | Commercial | $968 |
| PHP | Commercial | $968 |
| Priority Health | Commercial | $968 |
| Aetna | Commercial | $976 |
| Allied Benefit | Commercial | $976 |
| CHA | Commercial | $994 |
| Multiplan | Commercial | $1,033 |
| Plain Church | Commercial | $1,033 |
| Cigna Prof Benefit | Commercial | $1,059 |
| Caresource | IN Medicaid HIP | $1,678 |
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