Emergency visit, high (level 4) at Ascension Via Christi Rehabilitation Hospital. CPT 99284.
What Ascension Via Christi Rehabilitation Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$354–$2,649range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | 1369_aetna Rhks 20241101 | $354 |
| Default - 100 Percent Of Medicare Rates | 1016_default - 100 Percent O | $394 |
| Medicare Advantage Coventry | 1339_medicare Advantage Coventry Outpati | $394 |
| Medicare Advantage Humana | 1340_medicare Advantage Humana Outpatient | $394 |
| Medicare Advantage Other | 1341_medicare Advantage Other Outpatient 20 | $394 |
| Va | 1015_veterans Outpatient 20230101 | $394 |
| Vc Hope | 1342_medicare Advantage Vc Hope Outpatient 20250101 | $394 |
| Aarp Medicare Replacement | 1336_medicare Advantage Aarp Outpatient 20 | $398 |
| Allwell Medicare | 1337_medicare Advantage Allwell Outpatient 20250101 | $402 |
| Medicare Advantage Blue Cross Blue Shield | 1338_medicare Advantage Bl | $402 |
| Medicare Advantage UHC | 1343_rhks Medicare Advantage United Healthcar | $402 |
| Smarthealth | 1083_smarthealth Outpatient 20230101 | $551 |
| Ambetter Sunflower | 1003_ambetter Sunflower Outpatient 20230101 | $669 |
| United Healthcare Exchange | 1479_rhks United Healthcare Exchange Outp | $1,103 |
| Cigna | 1446_cigna Rhks 20250501 | $1,359 |
| Cigna | 1447_cigna Stks, Vwks 20250501 | $1,359 |
| Smarthealth | 1293_smarthealth Inpatient 20241001 | $1,449 |
| Coventry City Of Wichita | 318_stks, Vwks Coventry City Of Wichita 201 | $1,567 |
| Aetna Ed Level 3 2017 | 275_aetna Ed Level 3 2017 | $1,573 |
| Aetna Spirit Concierge Care | 1473_aetna Spirit Concierge Care Stks, V | $1,765 |
| Aetna Spirit Traditional | 1474_aetna Spirit Traditional Stks, Vwks 20 | $2,029 |
| Aetna: City Of Wichita | 643_aetna City Of Wichita Stks, Vwks 20200415 | $2,043 |
| Aetna | 1475_aetna Stks, Vwks 20250320 | $2,534 |
| United Health Care | 1466_united Health Care Stks, Vwks 20250701 | $2,608 |
| United Health Care | 1465_united Health Care Rhks 20250701 | $2,649 |
Inpatient
—cash price (self-pay)
—list price
$394–$1,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Default - 100 Percent Of Medicare Rates | 1490_default - 100 Percent O | $394 |
| Medicare Advantage Humana | 1499_medicare Advantage Humana Inpatient R | $394 |
| Medicare Advantage Other | 1501_medicare Advantage Other Inpatient Stk | $394 |
| Va | 1492_veterans Inpatient 20251001 | $394 |
| Vc Hope | 1502_medicare Advantage Vc Hope Inpatient 20251001 | $394 |
| Aarp Medicare Replacement | 1507_medicare Advantage Aarp Inpatient 202 | $398 |
| Medicare Advantage Coventry | 1500_medicare Advantage Coventry Inpatie | $398 |
| Allwell Medicare | 1497_medicare Advantage Allwell Inpatient 20251001 | $402 |
| Medicare Advantage Blue Cross Blue Shield | 1498_medicare Advantage Bl | $402 |
| Medicare Advantage UHC | 1509_rhks Medicare Advantage United Healthcar | $402 |
| Smarthealth | 1489_smarthealth Inpatient 20251001 | $551 |
| Ambetter Sunflower | 1491_ambetter Sunflower Inpatient 20251001 | $669 |
| United Healthcare Exchange | 1518_rhks United Healthcare Exchange Inpa | $1,103 |
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All common services at Ascension Via Christi Rehabilitation Hospital