Emergency visit, high (level 4) at Breckinridge Memorial Hospital. CPT 99284.
What Breckinridge Memorial Hospital publishes for this service, straight from its standard-charges file, last updated July 16, 2026.
Outpatient / ER
$320cash price (self-pay)
$639list price
$74.05–$639range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Medicaid | Blue Cross Medicaid | $74.05 |
| Wellcare Mcaid - All Other Plans | Wellcare Mcaid - All Other Plans | $74.05 |
| Aetna Better Health Medicaid | Aetna Better Health Medicaid | $74.05 |
| Tricare - All Plans | Tricare - All Plans | $207 |
| Molina Mcr Adv - All Plans | Molina Mcr Adv - All Plans | $221 |
| Caresource - All Plans | Caresource - All Plans | $230 |
| Wellcare Mcr Adv | Wellcare Mcr Adv | $230 |
| Aetna Mcr Adv | Aetna Mcr Adv | $230 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $230 |
| UHC Mcr Adv | UHC Mcr Adv | $230 |
| UHC Va Ccn | UHC Va Ccn | $230 |
| University Health Care Mcr Adv | University Health Care Mcr Adv | $230 |
| Ambetter Comm/Exch - All Plans | Ambetter Comm/Exch - All Plans | $253 |
| University Health Care - All Other Plans | University Health Care - Al | $270 |
| Humana Choicecare - All Plans | Humana Choicecare - All Plans | $479 |
| Aetna Commercial - All Other Plans | Aetna Commercial - All Other Plan | $479 |
| UHC Comm - All Other Plans | UHC Comm - All Other Plans | $543 |
| Blue Cross Mcare Select | Blue Cross Mcare Select | $639 |
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