Emergency visit, moderate (level 3) at Ascension Via Christi Hospital St. Teresa. CPT 99283.
What Ascension Via Christi Hospital St. Teresa publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$256–$2,112range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Default - 100 Percent Of Medicare Rates | 1016_default - 100 Percent O | $256 |
| Medicare Advantage Coventry | 1339_medicare Advantage Coventry Outpati | $256 |
| Medicare Advantage Humana | 1340_medicare Advantage Humana Outpatient | $256 |
| Medicare Advantage Other | 1341_medicare Advantage Other Outpatient 20 | $256 |
| Saint Lukes Health Systems | 1005_saint Luke Health System Outpatient | $256 |
| Va | 1015_veterans Outpatient 20230101 | $256 |
| Vc Hope | 1342_medicare Advantage Vc Hope Outpatient 20250101 | $256 |
| Via Christi Research | 1006_via Christi Research Outpatient 20230101 | $256 |
| Aarp Medicare Replacement | 1336_medicare Advantage Aarp Outpatient 20 | $259 |
| Allwell Medicare | 1337_medicare Advantage Allwell Outpatient 20250101 | $261 |
| Medicare Advantage Blue Cross Blue Shield | 1338_medicare Advantage Bl | $261 |
| Medicare Advantage UHC | 1344_stks, Vwks Medicare Advantage United Hea | $261 |
| Corizon | 1004_corizon Outpatient Stks, Vwks 20230101 | $320 |
| Smarthealth | 1083_smarthealth Outpatient 20230101 | $359 |
| Ambetter Sunflower | 1003_ambetter Sunflower Outpatient 20230101 | $435 |
| United Healthcare Exchange | 1477_stks, Vwks United Healthcare Exchang | $717 |
| Smarthealth | 1293_smarthealth Inpatient 20241001 | $880 |
| United Health Care | 1466_united Health Care Stks, Vwks 20250701 | $1,207 |
| Cigna | 1447_cigna Stks, Vwks 20250501 | $1,259 |
| Coventry City Of Wichita | 318_stks, Vwks Coventry City Of Wichita 201 | $1,307 |
| Aetna Spirit Concierge Care | 1473_aetna Spirit Concierge Care Stks, V | $1,471 |
| Aetna Ed Level 3 2017 | 275_aetna Ed Level 3 2017 | $1,573 |
| Aetna Spirit Traditional | 1474_aetna Spirit Traditional Stks, Vwks 20 | $1,692 |
| Aetna: City Of Wichita | 643_aetna City Of Wichita Stks, Vwks 20200415 | $1,703 |
| Aetna | 1475_aetna Stks, Vwks 20250320 | $2,112 |
Inpatient
—cash price (self-pay)
—list price
$256–$717range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Default - 100 Percent Of Medicare Rates | 1490_default - 100 Percent O | $256 |
| Medicare Advantage Humana | 1499_medicare Advantage Humana Inpatient R | $256 |
| Medicare Advantage Other | 1501_medicare Advantage Other Inpatient Stk | $256 |
| Saint Lukes Health Systems | 1493_saint Lukes Health System Inpatient | $256 |
| Va | 1492_veterans Inpatient 20251001 | $256 |
| Vc Hope | 1502_medicare Advantage Vc Hope Inpatient 20251001 | $256 |
| Via Christi Research | 1495_via Christi Research Inpatient 20251001 | $256 |
| Aarp Medicare Replacement | 1507_medicare Advantage Aarp Inpatient 202 | $259 |
| Medicare Advantage Coventry | 1500_medicare Advantage Coventry Inpatie | $259 |
| Allwell Medicare | 1497_medicare Advantage Allwell Inpatient 20251001 | $261 |
| Medicare Advantage Blue Cross Blue Shield | 1498_medicare Advantage Bl | $261 |
| Medicare Advantage UHC | 1508_stks, Vwks Medicare Advantage United Hea | $261 |
| Corizon | 1494_corizon Inpatient Stks, Vwks 20251001 | $320 |
| Smarthealth | 1489_smarthealth Inpatient 20251001 | $359 |
| Ambetter Sunflower | 1491_ambetter Sunflower Inpatient 20251001 | $435 |
| United Healthcare Exchange | 1519_stks, Vwks United Healthcare Exchang | $717 |
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All common services at Ascension Via Christi Hospital St. Teresa