Emergency visit, high (level 4) at Ochsner St. Martin Hospital. CPT 99284.
What Ochsner St. Martin Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$126cash price (self-pay)
$419list price
$92.18–$984range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Health Inc. - Medicare Advantage | All Payor | $92.18 |
| Blue Cross Blue Shield Of Louisiana Medicare Advantage Product(S) | Al | $92.18 |
| Healthy Blue Dual Advantage (HMO-D-Snp) | All Payor | $92.18 |
| Humana � Medicare Advantage | All Payor | $92.18 |
| Ochsner Health Plan | All Payor | $92.18 |
| Optum Va Ccn | All Payor | $92.18 |
| Peoples Health Network � Medicare Advantage | All Payor | $92.18 |
| United Healthcare - Medicare Advantage | All Payor | $92.18 |
| Wellcare Of Louisiana | All Payor | $92.18 |
| American Health Advantage Of Louisiana (Formerly Dignity Health Plan) | $94.95 |
| Triwest Military - Tricare | All Payor | $107 |
| Verity Commercial And First Choice Network | All Payor | $147 |
| Aetna Better Health (Healthy Louisiana) | All Payor | $152 |
| Amerihealth Caritas Louisiana (Healthy Louisiana) | All Payor | $152 |
| Healthy Blue (Healthy Louisiana) | All Payor | $152 |
| Humana � Managed Medicaid (Healthy Louisiana) | All Payor | $152 |
| Louisiana Healthcare Connections (Healthy Louisiana) | All Payor | $152 |
| United Healthcare Community Plan (Healthy Louisiana) | All Payor | $152 |
| Zelis | All Payor | $350 |
| Cigna Healthcare | All Payor | $356 |
| Aetna Health Inc. PPO/POS | All Payor | $381 |
| United Healthcare - Commercial HMO PPO | All Payor | $880 |
| Blue Cross Blue Shield Of Louisiana- Blue High-Performance Network | | $905 |
| Blue Cross Blue Shield Of Louisiana Blue Connect | All Payor | $905 |
| Blue Cross Blue Shield Of Louisiana HMO | All Payor | $984 |
| Blue Cross Blue Shield Of Louisiana PPO | All Payor | $984 |
Inpatient
$126cash price (self-pay)
$419list price
—range insurers pay
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