Emergency visit, high (level 4) at M Health Fairview Southdale Hospital. CPT 99284.
What M Health Fairview Southdale Hospital publishes for this service, straight from its standard-charges file, last updated February 6, 2026.
Outpatient / ER
$493cash price (self-pay)
$1,243list price
$81.32–$1,617range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross of Minnesota | PMAP | $228 |
| Medica | MSHO/Medicare Advantage SNP | $315 |
| Health Partners | Medicare Cost | $364 |
| Health Partners | PMAP | $371 |
| Itasca Medical Care | Managed Medicaid | $397 |
| Primewest | Managed Medicaid | $397 |
| South Country Health Alliance | PMAP | $397 |
| Itasca Medical Care | Medicare Advantage/MSHO | $424 |
| Primewest | MSHO | $424 |
| Sanford Health Plan | Medicare Advantage | $424 |
| Security Health Plan | Medicare Advantage | $424 |
| South Country Health Alliance | Medicare Advantage | $424 |
| United Healthcare | Medicare Advantage | $424 |
| WellCare | Medicare Advantage | $424 |
| Hennepin Health | PMAP | $429 |
| UCare | Medicare Advantage/MSHO | $430 |
| UCare | PMAP | $431 |
| Blue Cross of Minnesota | Medicare Advantage | $441 |
| Health Partners | Medicare Advantage | $449 |
| Medica | Medicare Advantage Non-SNP | $449 |
| Medica | Managed Medicaid/AccessAbility | $477 |
| Blue Cross of Minnesota | Aware Federal | $539 |
| Blue Cross of Minnesota | Aware/Blue Plus | $549 |
| America's PPO | EZCare | $746 |
| America's PPO | Health EZ | $746 |
| Health Partners | Federal | $753 |
| UCare | Individual and Family with M Health Fairview | $754 |
| Health Partners | Commercial | $767 |
| Health Partners | Cigna Commercial | $805 |
| America's PPO | Commercial | $895 |
Inpatient
$493cash price (self-pay)
$1,243list price
$640–$1,124range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| America's PPO | EZCare | $648 |
| Sanford Health Plan | Commercial | $732 |
| America's PPO | Health EZ | $734 |
| America's PPO | Commercial | $795 |
| Security Health Plan | Commercial | $933 |
| First Health | Commercial | $1,020 |
| MultiPlan | Commercial | $1,057 |
| Private Healthcare Systems | Commercial | $1,057 |
| Wisconsin Physician Services | Commercial | $1,119 |
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