Emergency visit, high (level 4) at IU Health Ball Memorial Hospital. CPT 99284.
What IU Health Ball Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$890cash price (self-pay)
$20,368list price
$247–$37,310range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Elevance Health | All IUHP Employee Plans | $247 |
| Elevance Health | All Managed Medicaid | $296 |
| Managed Health Services | All Government Medicaid | $296 |
| United Healthcare | All Managed Medicaid | $296 |
| Caresource | All Managed Medicaid | $296 |
| Caresource | All Government Medicaid HIP | $296 |
| Elevance Health | All Government Medicaid HIP | $296 |
| Managed Health Services | All Government Medicaid HIP | $296 |
| Aetna | All Managed Medicare | $444 |
| United Healthcare | All Managed Medicare | $444 |
| Elevance Health | All Managed Medicare - Out of network | $444 |
| Elevance Health | All Managed Medicare - In network | $444 |
| Health Alliance | HMO/PPO Managed Medicare | $444 |
| Indiana University Health | All Managed Medicare | $444 |
| Zing Health | All Managed Medicare | $444 |
| Humana | All Managed Medicare HMO | $444 |
| Wellcare by Allwell | All Managed Medicare | $453 |
| Humana | All Managed Medicare PPO | $453 |
| Elevance Health | HMO - Anthem Pathway Essentials | $488 |
| United Healthcare | ASO | $599 |
| Caresource | All Marketplace Plans | $666 |
| Ambetter | All HMO Marketplace Plans | $732 |
| Elevance Health | All Traditional Plans | $1,000 |
| Elevance Health | All PPO | $1,000 |
| Elevance Health | All HMO/POS | $1,000 |
| SIHO Insurance Services | ASO - Smithville | $1,109 |
| Encore Health Network | EPO - Elite+ Plans | $1,109 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $1,442 |
| United Healthcare | All Managed Care | $3,892 |
| SIHO Insurance Services | PPO - Union Health | $8,351 |
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