Emergency visit, high (level 4) at Franciscan Health Dyer. CPT 99284.
What Franciscan Health Dyer publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$745cash price (self-pay)
$2,760list price
$296–$3,528range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid Illinois [1091] | In Mcd-Nir-Dyer | $296 |
| Medicaid [1092] | In Mcd-Nir-Dyer | $296 |
| Mdwise [1175] | In Mcd-Nir-Dyer | $296 |
| Alt Traditional Medicaid Secondary [109200] | In Mcd-Nir-Dyer | $296 |
| Medicaid [1092] | Anthem Medicaid [109201] | $296 |
| Medicaid [1092] | Medicaid In Traditional [109206] | $296 |
| Managed Health Services [1302] | In Mcd Dyer Mhs 112% Of In Mcd | $305 |
| Medicaid [1092] | In Mcd Dyer Caresource 120% Of In Mcd | $355 |
| Medicare [1099] | Medicare-Nir-Dyer | $441 |
| Medicare Replacement [2003] | Medicare-Nir-Dyer | $441 |
| Workers Comp [1172] | Workers Comp - Nir - Dyer | $883 |
| Blue Cross [1014] | Anthem Franciscan Employee Copps- All Locations | $1,068 |
| Cigna [1037] | Cigna Localplus-Nid | $1,176 |
| Blue Cross [1014] | Anthem Healthsync POS With Copps - Dyer | $1,258 |
| Blue Cross Illinois [1210] | St Anthony Health-Nir-Stmar&Fhm&Stant Mc | $1,380 |
| Blue Cross [1014] | Anthem Blue Access PPO With Copps - Dyer | $1,406 |
| Unicare [1150] | Anthem Blue Access PPO With Copps - Dyer | $1,406 |
| Blue Cross Illinois [1210] | Anthem Blue Access PPO With Copps - Dyer | $1,406 |
| Blue Cross Out Of State [1211] | Anthem Blue Access PPO With Copps - D | $1,406 |
| Alt Payer Illinois Blue Cross [121002] | Anthem Blue Access PPO With C | $1,406 |
| Alt Payer Indiana Blue Cross [121003] | Anthem Blue Access PPO With Co | $1,406 |
| Cigna [1037] | Cigna-Nid-Hammond-Dyer-Munster-Crn Point | $1,747 |
| Great West Insurance [1055] | Cigna-Nid-Hammond-Dyer-Munster-Crn Point | $1,747 |
| Managed Care [2000] | Cigna-Nid-Hammond-Dyer-Munster-Crn Point | $1,747 |
| Commercial [2001] | Cigna-Nid-Hammond-Dyer-Munster-Crn Point | $1,747 |
| Managed Care [2000] | Private Hc System-Nid-Hammd-Dyer-Munster | $1,786 |
| Aetna [1005] | Aetna-Nid-Dyer-Munster-Crn Point | $2,050 |
| Managed Care [2000] | Aetna-Nid-Dyer-Munster-Crn Point | $2,050 |
| Blue Cross Illinois [1210] | Bc/Bs Of Illinois HMO-Nid-Hammond-Dyer | $2,070 |
| United Healthcare [1156] | UHC Nid-Hammond-Dyer-Munster-Crn Point | $2,760 |
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