Emergency visit, high (level 4) at Sullivan County Community Hospital. CPT 99284.
What Sullivan County Community Hospital publishes for this service, straight from its standard-charges file, last updated June 10, 2026.
Outpatient / ER
$949cash price (self-pay)
$1,266list price
$75.80–$1,266range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Mhs Mcaid - All Other Plans | Mhs Mcaid - All Other Plans | $75.80 |
| Ambetter Comm-Exch - All Plans | Ambetter Comm-Exch - All Plans | $380 |
| BCBS Essential | BCBS Essential | $380 |
| Va Ccn - All Plans | Va Ccn - All Plans | $380 |
| BCBS Mcr Adv | BCBS Mcr Adv | $380 |
| Mdwise Mcr Adv | Mdwise Mcr Adv | $380 |
| Humana Mcr Adv | Humana Mcr Adv | $384 |
| Mhs Hlthy In Mcaid | Mhs Hlthy In Mcaid | $426 |
| BCBS Pathway X | BCBS Pathway X | $451 |
| BCBS Healthsync | BCBS Healthsync | $451 |
| BCBS HMO | BCBS HMO | $557 |
| BCBS Pathway | BCBS Pathway | $564 |
| BCBS PPO | BCBS PPO | $564 |
| BCBS Trad - All Other Plans | BCBS Trad - All Other Plans | $668 |
| Siho - All Plans | Siho - All Plans | $949 |
| Humana Comm - All Other Plans | Humana Comm - All Other Plans | $1,076 |
| UHC All Payer - All Plans | UHC All Payer - All Plans | $1,076 |
| Mdwise Mcaid - All Other Plans | Mdwise Mcaid - All Other Plans | $1,266 |
| Humana Mcaid | Humana Mcaid | $1,266 |
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