Emergency visit, high (level 4) at IU Health Bloomington Hospital. CPT 99284.
What IU Health Bloomington Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$1,032cash price (self-pay)
$20,368list price
$296–$37,310range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Elevance Health | All Managed Medicaid | $296 |
| United Healthcare | All Managed Medicaid | $296 |
| Managed Health Services | All Government 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 |
| Elevance Health | All Managed Medicare - In network | $443 |
| Indiana University Health | All Managed Medicare | $443 |
| Elevance Health | All Managed Medicare - Out of network | $443 |
| Aetna | All Managed Medicare | $443 |
| Humana | All Managed Medicare HMO | $443 |
| United Healthcare | All Managed Medicare | $443 |
| Zing Health | All Managed Medicare | $443 |
| Health Alliance | HMO/PPO Managed Medicare | $443 |
| Humana | All Managed Medicare PPO | $452 |
| Wellcare by Allwell | All Managed Medicare | $452 |
| Elevance Health | HMO - Anthem Pathway Essentials | $487 |
| Elevance Health | All IUHP Employee Plans | $498 |
| United Healthcare | ASO | $598 |
| Caresource | All Marketplace Plans | $665 |
| Ambetter | All HMO Marketplace Plans | $731 |
| Encore Health Network | EPO - Elite+ Plans | $1,108 |
| SIHO Insurance Services | ASO - Smithville | $1,108 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $1,442 |
| Elevance Health | All PPO | $1,500 |
| Elevance Health | All Traditional Plans | $1,500 |
| Elevance Health | All HMO/POS | $1,500 |
| Suburban Health Organization | PPO - Direct | $10,897 |
| Deaconess Health System | All Managed Care | $11,813 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.