Emergency visit, high (level 4) at Northwest Health - Porter. CPT 99284.
What Northwest Health - Porter publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$997cash price (self-pay)
$3,694list price
$110–$3,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Veterans Eval Services | Veterans Eval Services | $110 |
| One Call | One Call Care Diagnostics WC | $111 |
| Anthem | Anthem IN Medicaid | $296 |
| CareSource | Caresource HHW IN Medicaid | $296 |
| CareSource | CareSource IN HIP | $296 |
| Humana PathWays IN Medicaid | Humana PathWays IN Medicaid | $296 |
| Indiana Medicaid | IN Medicaid | $296 |
| Indiana Medicaid Non Par | IN Medicaid Non Par | $296 |
| MHS | MHS HCC IN Medicaid | $296 |
| Managed Health Services | MHS HHW IN Medicaid | $296 |
| Managed Health Services | MHS IN HIP | $296 |
| UHC | UHC HCC IN Medicaid | $296 |
| UHC PathWays IN Medicaid | UHC PathWays IN Medicaid | $296 |
| NODE Tricare | NODE Tricare | $419 |
| Aetna | Aetna HMO/POS | $630 |
| Align Network | Align Network | $706 |
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $887 |
| First Health Coventry | First Health | $995 |
| Self Pay | Self Pay | $997 |
| Cigna | Cigna ALL | $1,027 |
| Physicians Health Plan | PHP Options | $1,416 |
| PHP Freedom | PHP Freedom Network | $1,526 |
| Sagamore Health Network | Sagamore Indiana Financial | $1,633 |
| Lutheran Preferred | Lutheran Preferred Fixed 2 | $1,662 |
| Aetna | Aetna PPO | $1,784 |
| Sagamore Health Network | Sagamore Anthem Groups | $1,817 |
| Lutheran Preferred | Lutheran Preferred Exclusive Plus | $1,847 |
| Sagamore Health Network | Sagamore Select Plus | $2,187 |
| Lutheran Preferred | Lutheran Preferred Choice | $2,216 |
| United Healthcare | UHC APA | $2,478 |
Inpatient
$1,330cash price (self-pay)
$3,694list price
$887–$3,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $887 |
| Cigna | Cigna ALL | $1,027 |
| Self Pay | Self Pay | $1,330 |
| Physicians Health Plan | PHP Options | $1,416 |
| PHP Freedom | PHP Freedom Network | $1,526 |
| Sagamore Health Network | Sagamore Indiana Financial | $1,633 |
| Sagamore Health Network | Sagamore Anthem Groups | $1,817 |
| Aetna | Aetna PPO | $1,873 |
| Sagamore Health Network | Sagamore Select Plus | $2,187 |
| Lutheran Preferred | Lutheran Preferred Choice | $2,216 |
| Southeastem Indiana Health Operations | SIHO Outside Counties | $2,586 |
| Prime Health | PRIME HEALTH SERVICES | $2,771 |
| Prime Health | Prime Health Services Auto | $2,771 |
| Southeastem Indiana Health Operations | SIHO Inside Counties | $2,771 |
| Encore Health | Encore Health PPO | $2,955 |
| Multiplan/PHCS | Multiplan Complementary | $3,103 |
| Multiplan/PHCS | PHCS Savility Primary Network | $3,103 |
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