Emergency visit, high (level 4) at Mercy Hospital. CPT 99284.
What Mercy Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$3.18–$2,581range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicare Advantage | Medicare | $67.14 |
| Rx Allwin | Medicare | $67.14 |
| Carelon Health Medicaid | Carelon Medicaid | $92.14 |
| Tufts Medicare Advantage | Tufts Medicare Advantage | $490 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $490 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $490 |
| Medigold Medicare Advantage | Mount Carmel Health Plan | $490 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $495 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $500 |
| Wellcare Medicare | Wellcare Medicare Advantage | $515 |
| Fallon Health Medicare Advantage | Fallon Navicare Medicare Advantage | $515 |
| Multiplan | Multiplan | $576 |
| Blue Shield - Id (Regence) | BCBS PPO | $628 |
| Blue Cross - Me (Anthem) | BCBS PPO | $628 |
| Blue Cross - La | BCBS PPO | $628 |
| Blue Cross - Md (Carefirst) | BCBS PPO | $628 |
| Blue Cross - MA | BCBS Indemnity | $628 |
| Blue Cross - Oh (Anthem) | BCBS PPO | $628 |
| Blue Cross - Ak (Premera) | BCBS PPO | $628 |
| Blue Cross - Al | BCBS PPO | $628 |
| Blue Cross - Az | BCBS PPO | $628 |
| Blue Cross - CA (Anthem) | BCBS PPO | $628 |
| Blue Cross - Ar | BCBS PPO | $628 |
| Blue Cross - Tn | BCBS PPO | $628 |
| Blue Cross - Ri | BCBS PPO | $628 |
| Blue Cross - Federal | BCBS PPO | $628 |
| BCBS Generic | BCBS PPO | $628 |
| Blue Cross - Va (Carefirst) | BCBS PPO | $628 |
| Blue Cross - Wa (Premera) | BCBS PPO | $628 |
| Wc Domestic | BCBS PPO | $628 |
Inpatient
$296cash price (self-pay)
$296list price
$56.62–$296range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Heatlhcomp | Workers Comp | $56.62 |
| Rx Restat | Workers Comp | $56.62 |
| Jai Medical System | Medicaid | $87.75 |
| Freedom First Healthcare | Medicaid | $87.75 |
| Caresource Medicaid | Medicaid | $87.75 |
| Medicaid - Me | Medicaid | $87.75 |
| Medicaid - Md | Medicaid | $87.75 |
| Medicaid - MA | Medicaid | $87.75 |
| Medicaid - Ky | Medicaid | $87.75 |
| Medicaid - La | Medicaid | $87.75 |
| Medicaid - Ia | Medicaid | $87.75 |
| Medicaid - Pa | Medicaid | $87.75 |
| Molina Medicare Advantage | Medicare | $116 |
| Rx Allwin | Medicare | $116 |
| Tufts Medicare Advantage | Tufts Medicare Advantage | $116 |
| Tristate Benefit Solutions Medicare Advantage | Medicare | $116 |
| Sunshine Health Medicare Advantage | Medicare | $116 |
| Univera Healthcare Medicare Advantage | Medicare | $116 |
| Blue Cross - Ne Medicare Advantage | Medicare | $116 |
| Blue Cross - Ky (Anthem) Medicare Advantage | Medicare | $116 |
| Blue Cross - Ga (Anthem) Medicare Advantage | Medicare | $116 |
| Upmc Medicare Advantage | Medicare | $116 |
| Blue Cross - NY (Anthem) Medicare Advantage | Medicare | $116 |
| Connecticare Vip Medicare | Medicare | $116 |
| Total Healthcare Medicare Snp | Medicare | $116 |
| Hap Empowered Mi Health Link Medicare Dual | Medicare | $116 |
| Mercyone Cedar Valley | Medicare | $116 |
| Blue Shield - Pa (Highmark) Medicare Advantage | Medicare | $116 |
| Martins Point Generations Advantage | Medicare | $116 |
| Tribute Health Plans | Medicare | $116 |
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