Emergency visit, high (level 4) at Essentia Health St. Mary's-Detroit Lakes. CPT 99284.
What Essentia Health St. Mary's-Detroit Lakes publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$859cash price (self-pay)
$1,338list price
$296–$2,188range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica Access | Medicaid | $416 |
| Itasca Med Care | Medicaid | $426 |
| Primewest | Medicaid | $427 |
| Advocare/Security Health | Medicare | $448 |
| BLUE CROSS MEDICARE ADVANTAGE CORE | Medicare | $448 |
| Freedom Blue PPO | Medicare | $448 |
| HEALTHPARTNERS CARE MSHO / MCR ADV | Medicare | $448 |
| IMCARE MSHO PCC PRIME | Medicare | $448 |
| IMCARE MSHO REF REQ | Medicare | $448 |
| MEDICA ADVANTAGE SOLUTIONS | Medicare | $448 |
| MEDICA MSHO/Dual Solutions | Medicare | $448 |
| MEDICA PRIME SOLUTION GROUP | Medicare | $448 |
| MEDICARE ADV PFFS | Medicare | $448 |
| ND VA ADMINISTRATION | Medicare | $448 |
| OUT OF STATE BCBS MEDICARE ADVANTAGE | Medicare | $448 |
| PRIMEWEST MSHO | Medicare | $448 |
| Platinum Blue/Vantage Blue | Medicare | $448 |
| SECURE BLUE MSHO | Medicare | $448 |
| SECURITY HEALTH MEDICARE | Medicare | $448 |
| UBH COST PLAN | Medicare | $448 |
| UBH MSHO/MEDICARE REPLACEMENT | Medicare | $448 |
| BCBS MN | Medicaid | $449 |
| BCBS PLUS PMAP PCC PRIME | Medicaid | $449 |
| HealthPartners CARE PMAP | Medicaid | $520 |
| Sanford HealthPlan | Commercial-NDPERS | $664 |
| Sanford HealthPlan | Commercial | $679 |
| HealthPartners | SHP | $899 |
| Cigna | Commercial | $982 |
| HealthPartners PCC Prime | Commercial | $982 |
| HealthPartners | Commercial | $982 |
Inpatient
$859cash price (self-pay)
$1,338list price
$574–$1,151range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford HealthPlan | Commercial-NDPERS | $574 |
| Sanford HealthPlan | Commercial | $604 |
| Ucare | Commercial | $880 |
| BCBS MN | Medicaid | $894 |
| BCBS PLUS PMAP PCC PRIME | Medicaid | $894 |
| WEA | Commercial-Narrow Network | $963 |
| MN BCBS Commercial | BCBS MN | $994 |
| BCBS WI | Commercial | $1,017 |
| WEA | Commercial | $1,030 |
| America's PPO | Commercial | $1,037 |
| WPS | Commercial | $1,111 |
| Aetna First Health | Commercial | $1,137 |
| HealthEOS | Commercial | $1,151 |
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All common services at Essentia Health St. Mary's-Detroit Lakes