Emergency visit, moderate (level 3) at IU Health White Memorial Hospital. CPT 99283.
What IU Health White Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$408cash price (self-pay)
$1,309list price
$296–$1,303range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Health Services | All Government Medicaid | $296 |
| Caresource | All Managed Medicaid | $296 |
| United Healthcare | All Managed Medicaid | $296 |
| Elevance Health | All Managed Medicaid | $296 |
| Managed Health Services | All Government Medicaid HIP | $296 |
| Elevance Health | All Government Medicaid HIP | $296 |
| Caresource | All Government Medicaid HIP | $296 |
| Encore Health Network | PPO | $484 |
| SIHO Insurance Services | PPO - Union Health | $537 |
| Elevance Health | All PPO | $665 |
| Indiana Health Network (IHN) | All Managed Care | $681 |
| Suburban Health Organization | PPO - Direct | $687 |
| Aetna | HMO - Coventry Plans | $700 |
| Aetna | PPO/POS | $700 |
| Aetna | POS - Cox Medical Plans | $704 |
| Aetna | PPO - IN Preferred | $704 |
| Aetna | PPO - First Health | $759 |
| Deaconess Health System | All Managed Care | $759 |
| Aetna | PPO - NAP | $759 |
| Community Health Direct | HMO - LaPorte Regional Plans | $772 |
| Parkview Health | HMO - Employee Plans | $809 |
| Unified Group Services | HMO | $812 |
| Cigna | HMO - Open Access | $825 |
| Cigna | HMO | $825 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $825 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $825 |
| Cigna | HMO/POS - Arnett Hospital Plans | $825 |
| Cigna | PPO | $825 |
| Elevance Health | All Traditional Plans | $902 |
| Lutheran Health Network | All Managed Care | $916 |
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