Emergency visit, high (level 4) at Sanford Jackson Hospital. CPT 99284.
What Sanford Jackson Hospital publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$1,182cash price (self-pay)
$1,477list price
$358–$1,388range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $358 |
| Ucare | Medicaid Managed Care | $447 |
| Sanford Health Plan Align | Medicare Replacement | $464 |
| Ucare | Medicare Replacement | $498 |
| Wellmark SD | Medicare Replacement | $498 |
| Aetna | Medicare Replacement | $502 |
| Great Plains Medicare Advantage | Medicare Replacement | $502 |
| Health Partners | Medicare Replacement | $502 |
| United Healthcare | Medicare Replacement | $502 |
| Primewest | Medicare Replacement | $512 |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $512 |
| Primewest | Medicaid Managed Care | $552 |
| Sanford Health Plan | Group Health/True | $791 |
| Sanford Health Plan | SD Exchange True | $791 |
| Security Health Plan | Commercial | $812 |
| Sanford Health Plan | Commercial/ND Pers | $931 |
| Sanford Health Plan | SD Exchange Commercial | $931 |
| Health Partners | State Employees | $1,018 |
| Health Partners | Commercial | $1,182 |
| Blue Cross Blue Shield of Minnesota | State Employees | $1,208 |
| United Healthcare | Commercial + Top 20 | $1,233 |
| Aetna | Commercial | $1,284 |
| Ucare | Commercial | $1,298 |
| Medica | Choice | $1,298 |
| Cigna | Commercial | $1,329 |
| First Choice Health Network | Commercial | $1,329 |
| Healthez | Commercial | $1,329 |
| Multiplan | Commercial | $1,329 |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,367 |
| Medica | Elect | $1,388 |
Inpatient
$1,182cash price (self-pay)
$1,477list price
$791–$1,397range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford Health Plan | Group Health/True | $791 |
| Sanford Health Plan | SD Exchange True | $791 |
| Security Health Plan | Commercial | $812 |
| Sanford Health Plan | Commercial/ND Pers | $931 |
| Sanford Health Plan | SD Exchange Commercial | $931 |
| Health Partners | State Employees | $1,018 |
| Health Partners | Commercial | $1,182 |
| United Healthcare | Commercial + Top 20 | $1,233 |
| Aetna | Commercial | $1,284 |
| Ucare | Commercial | $1,298 |
| Medica | Choice | $1,306 |
| Cigna | Commercial | $1,329 |
| First Choice Health Network | Commercial | $1,329 |
| Healthez | Commercial | $1,329 |
| Multiplan | Commercial | $1,329 |
| Medica | Elect | $1,397 |
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