Emergency visit, high (level 4) at Providence Medical Center. CPT 99284.
What Providence Medical Center publishes for this service, straight from its standard-charges file, last updated March 17, 2026.
Outpatient / ER
$393cash price (self-pay)
$2,152list price
$58.32–$1,989range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Aetna Medicaid Adjusted Rate | $58.32 |
| Traditional Medicaid | Traditional Medicaid | $105 |
| UHC | UHC Medicaid | $105 |
| Celtic | Celtic Medicaid | $107 |
| Healthy Blue | Healthy Blue Medicaid (01/01/2025 to 12/31/2026) | $107 |
| Aetna | Aetna Medicare | $393 |
| Cigna | Cigna Healthspring | $393 |
| Health Net Federal Services - Tricare | Health Net Federal Services - | $393 |
| Midland Care Connection | Midland Care Connection | $393 |
| Traditional Medicare | Traditional Medicare | $393 |
| Tricare | Tricare | $393 |
| UHC | UHC Medicare | $393 |
| UHC | UHC Va Ccn | $393 |
| Celtic | Celtic Medicare | $413 |
| Healthy Blue | Healthy Blue Medicare | $413 |
| Kansas Superior Select | Kansas Superior Select | $413 |
| Corizon | Corizon | $511 |
| Celtic | Home State Health Plan Ins Exchange | $531 |
| Employer Direct Healthcare | Employer Direct Healthcare Commercial | $550 |
| UHC | UHC Commercial Exchange | $550 |
| Well Path Prison | Well Path Prison | $550 |
| Centurion | Centurion | $590 |
| Naphcare | Naphcare | $609 |
| BCBS | BCBS Exchange | $629 |
| Celtic | Celtic Ins Exchange | $629 |
| BCBS | BCBS Select | $727 |
| UHC | UHC Commercial | $1,666 |
| UHC Ad-hoc | UHC Commercial | $1,703 |
| BCBS | BCBS HMO PPO | $1,856 |
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