Emergency visit, high (level 4) at Maple Grove Hospital. CPT 99284.
What Maple Grove Hospital publishes for this service, straight from its standard-charges file, last updated September 25, 2026.
Outpatient / ER
$558cash price (self-pay)
$1,059list price
$341–$1,076range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross [1021] | Mgh BCBS Pmap | $341 |
| Medicaid [1087] | Mgh Medicaid Mn | $356 |
| Blue Cross [1021] | Mgh BCBS Msho | $431 |
| Humana [2203] | Mgh Humana Med Adv | $431 |
| Medicare [1088] | Mgh Medicare | $431 |
| Ucare [1148] | Mgh Ucare Pmap | $431 |
| Health Partners [1061] | Mgh Hp Med Adv | $432 |
| Medica [1086] | Mgh Medica Med Adv | $435 |
| Ucare [1148] | Mgh Ucare Med Adv | $444 |
| Blue Cross [1021] | Mgh BCBS Med Adv | $444 |
| Ucare [1148] | Mgh Ucare Msho | $444 |
| United Healthcare [2204] | Mgh UHC Med Adv | $448 |
| Allina Health-Aetna [2201] | Mgh Allina Health Aetna Medicare | $468 |
| Medica [1086] | Medica Choice Care | $521 |
| Medica [1086] | Mgh Medica Msho | $531 |
| America'S PPO [1010] | America'S PPO Healthez Reimbursement Contract | $717 |
| America'S PPO [1010] | America'S PPO Reimbursement Contract | $762 |
| Blue Cross [1021] | Mgh Xr Hb BCBS Federal | $771 |
| Blue Cross [1021] | Mgh Xr Hb BCBS Aware | $784 |
| Ucare [1148] | Mgh Ucare Ifb | $788 |
| AETNA [2200] | Aetna Commercial/First Health | $794 |
| Phcs [1172] | Phcs Reimbursement Contract | $794 |
| Multiplan [1176] | Multiplan Reimbursement Contract | $847 |
| Medica [1086] | Medica Acclaim | $976 |
| Medica [1086] | Medica Fv Nm - Aco Vantage | $1,002 |
| MEDICA [1086] | MEDICA COMMERCIAL (With WH) | $1,076 |
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