Emergency visit, high (level 4) at Saint Luke's South Hospital. CPT 99284.
What Saint Luke's South Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$1,460cash price (self-pay)
$2,433list price
$105–$2,433range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid Managed Care (Ks) [2252] | UHC Community Plan Of Ks [22508] | $105 |
| Medicaid Managed Care (Ks) [2252] | Healthy Blue Kansas [22577] | $109 |
| Medicaid Managed Care (Ks) [2252] | Zzzaetna Better Health Of Kansas [ | $109 |
| Medicaid Managed Care (Ks) [2252] | Sunflower State Health [22505] | $116 |
| Medicaid Managed Care (Mo) [2250] | Healthy Blue Missouri [22572] | $363 |
| Medicaid Managed Care (Mo) [2250] | UHC Community Plan Of Mo [22517] | $363 |
| Medicaid Managed Care (Mo) [2250] | Home State Health Plan [22506] | $545 |
| United Healthcare [3000] | UHC Core Essential [30018] | $771 |
| United Healthcare [3000] | UHC Core Essentials All Savers [30019] | $771 |
| Transplants-Case Rates [5750] | Optum Commercial Heart E&P [57501] | $852 |
| Transplants-Case Rates [5750] | Optum MA Heart E&P [57512] | $852 |
| Cigna [7000] | Cigna Bjc Flex Or HDHP [70017] | $888 |
| Transplants-Case Rates [5750] | Medica Transplant [57520] | $973 |
| Blue Cross Blue Shield [4000] | Freedom Network Select [40021] | $1,095 |
| Blue Cross Blue Shield [4000] | Freedom Network Select Healthlink PPO | $1,095 |
| Blue Cross Blue Shield [4000] | Freedom Network Select Php [40001] | $1,095 |
| Blue Cross Blue Shield [4000] | Zzzfreedom Network Select Cerner [4000 | $1,095 |
| First Health [5512] | First Health Medishare [55122] | $1,442 |
| First Health [5512] | First Health Misc [55116] | $1,442 |
| First Health [5512] | First Health Repricing Addrs [55113] | $1,442 |
| First Health [5512] | First Health Uprehs [55119] | $1,442 |
| First Health [5512] | Zzzfirst Health Benefit Management [55117] | $1,442 |
| Transplants-Case Rates [5750] | Cigna Lifesource [57511] | $1,460 |
| Blue Cross Blue Shield [4000] | Freedom Network Healthlink [40019] | $1,620 |
| Blue Cross Blue Shield [4000] | Freedom Network Php [40002] | $1,620 |
| Cigna [7000] | Cigna Indemnity [70004] | $1,703 |
| Blue Cross Blue Shield [4000] | Bc Kc Preferred Care [40017] | $1,779 |
| Blue Cross Blue Shield [4000] | Bc Of Ks Exchange HMO [40026] | $1,779 |
| Blue Cross Blue Shield [4000] | Bc Out Of Area Pref Care [40010] | $1,779 |
| Commercial-Contracted [8000] | Phcs Multiplan [80056] | $1,825 |
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