Emergency visit, high (level 4) at Ochsner LSU Health Shreveport - St. Mary Medical Center. CPT 99284.
What Ochsner LSU Health Shreveport - St. Mary Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$568cash price (self-pay)
$2,029list price
$379–$2,467range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military � Tricare | All Payor | $379 |
| Zelis | All Payor | $387 |
| (Healthy Louisiana) And Healthy Blue Dual Advantage (HMO-D-Snp) | All | $393 |
| Aetna Health Inc. - Medicare Advantage | All Payor | $393 |
| Blue Cross Blue Shield Of Louisiana Medicare Advantage Product(S) | Al | $393 |
| Humana � Medicare Advantage | All Payor | $393 |
| Optum Va Ccn | All Payor | $393 |
| Peoples Health Network � Medicare Advantage | All Payor | $393 |
| United Healthcare - Medicare Advantage | All Payor | $393 |
| United Healthcare D-Snp (Dual Eligible Special Needs Plan) | All Payor | $393 |
| Aetna Better Health (Healthy Louisiana) | All Payor | $409 |
| Amerihealth Caritas Louisiana (Healthy Louisiana) | All Payor | $409 |
| Healthy Blue (Formerly Amerigroup Louisiana Inc.) | All Payor | $409 |
| Humana � Managed Medicaid (Healthy Louisiana) | All Payor | $409 |
| Louisiana Healthcare Connections (Healthy Louisiana) | All Payor | $409 |
| United Healthcare Community Plan (Healthy Louisiana) | All Payor | $409 |
| Vantage Health Plan - Commercial | All Payor | $550 |
| Aetna Health Inc. PPO/POS | All Payor | $617 |
| First Health Network | All Payor | $617 |
| Verity Health Network � Lsu First Choice | All Payor | $662 |
| Cigna Healthcare | All Payor | $816 |
| Blue Cross Blue Shield Of Louisiana- Blue High-Performance Network | | $821 |
| Blue Cross Blue Shield Of Louisiana Blue Connect | All Payor | $821 |
| Blue Cross Blue Shield Of Louisiana HMO | All Payor | $821 |
| Blue Cross Blue Shield Of Louisiana PPO | All Payor | $944 |
| Healthcomp PPO (Formerly Gilsbar 360 | All Payor | $981 |
| Multiplan/Phcs/American Lifecare | All Payor | $1,420 |
| United Healthcare - Commercial Heritage | All Payor | $1,956 |
| United Healthcare - Commercial HMO PPO | All Payor | $2,467 |
Inpatient
$568cash price (self-pay)
$2,029list price
—range insurers pay
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All common services at Ochsner LSU Health Shreveport - St. Mary Medical Center