Emergency visit, moderate (level 3) at Memorial Hospital of South Bend. CPT 99283.
What Memorial Hospital of South Bend publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$537cash price (self-pay)
$826list price
$155–$900range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| McLaren | MI Medicaid | $155 |
| UHC | MI Medicaid | $155 |
| Anthem | Commercial (Granger) | $198 |
| Devoted Healthcare | Medicare Advantage | $235 |
| Anthem | Exchange | $290 |
| Anthem | Medicare Advantage | $290 |
| Humana | Medicare Advantage | $290 |
| PACE | Medicare | $290 |
| UHC | Medicare Advantage | $290 |
| Aetna | Medicare Advantage | $331 |
| Caresource | Exchange | $464 |
| Anthem | HealthSync | $466 |
| CHA | Employer Group 4 | $496 |
| Immergrun | Commercial | $496 |
| MHS | Exchange | $530 |
| Anthem | Commercial (excludes Granger) | $533 |
| Plain Church | Commercial | $548 |
| Anthem | Workers Compensation | $551 |
| Cigna | OAP | $578 |
| UHC | Commercial | $596 |
| Aetna | Commercial | $608 |
| Multiplan | Commercial | $611 |
| CHA | Employer Group 5 | $620 |
| Humana | Commercial | $636 |
| CHA | Employer Group 6 | $661 |
| Cigna BH | Commercial | $661 |
| Cigna | PPO | $677 |
| Heartland | Hospice | $826 |
Inpatient
$537cash price (self-pay)
$826list price
$165–$677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Healthcare | Medicare Advantage | $165 |
| Multiplan | Commercial | $537 |
| Cigna | OAP | $578 |
| UHC | Commercial | $596 |
| Humana | Commercial | $603 |
| Aetna | Commercial | $608 |
| CHA | Employer Group 5 | $620 |
| CHA | Employer Group 6 | $661 |
| Cigna BH | Commercial | $661 |
| Immergrun | Commercial | $661 |
| Plain Church | Commercial | $661 |
| Cigna | PPO | $677 |
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