Emergency visit, high (level 4) at Mercy Hospital Boonville. CPT 99284.
What Mercy Hospital Boonville publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$316cash price (self-pay)
$1,324list price
$12.00–$1,204range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid [20240] | Hb Bnvar Ok Medicaid | $379 |
| Aetna Medicaid Contracted [320009] | Hb Bnvar Ok Managed Medicaid | $379 |
| Humana Medicaid Contracted [320486] | Hb Bnvar Ok Managed Medicaid | $379 |
| Oklahoma Complete Health Medicaid Contracted [320485] | Hb Bnvar Ok MA | $379 |
| Medicare [20244] | Hb Bnvar Medicare | $386 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Bnvar Uh | $386 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Bnv | $386 |
| Nhc Advantage Medicare Contracted [320282] | Hb Bnvar Managed Medicare | $386 |
| Humana Medicare Advantage Contracted [320194] | Hb Bnvar Humana Mcr | $386 |
| Humana Medicare Advantage Contracted [320194] | Hb Bnvar Managed Medic | $386 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Bnvar Managed | $386 |
| Devoted Health Medicare Contracted [320500] | Hb Bnvar Devoted Health | $402 |
| Cigna Medicare Advantage Contracted [320072] | Hb Bnvar Healthspring 1 | $406 |
| Healthspring Medicare Advantage Contracted [320526] | Hb Bnvar Healths | $406 |
| Novasys Contracted [320285] | Hb Bnvar Novasys Ambetter Exchange | $533 |
| Home State Health Plan Contracted [320187] | Hb Bnvar Novasys Ambetter | $533 |
| Centivo Contracted [320505] | Hb Bnvar Centivo Mcr | $638 |
| Blue Cross And Blue Shield [20053] | Hb Bnvar Blue Cross | $806 |
| Mc Anthem [20455] | Hb Bnvar Blue Cross | $806 |
| Usable Contracted [320409] | Hb Bnvar Blue Cross | $806 |
| Multiplan Contracted [320270] | Hb Bnvar Multiplan | $1,050 |
| Qual Choice Contracted [320324] | Hb Ftsm,Wldar,Ozkar,Prsar, Bnvar Qua | $1,108 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar,B | $1,116 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar D | $1,116 |
| Yuzu Health Contracted [320521] | Hb Wldar,Ozkar,Prsar,Bnvar, Bryvl De | $1,116 |
| Preferred Health Plan Contracted [320522] | Hb Bnvar Network Affiliati | $1,116 |
| Edison Health Solutions Contracted [320502] | Hb Wldar,Ozkar,Prsar,Bnv | $1,116 |
| Ebms Contracted [320493] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv Crader | $1,116 |
| Reflect Health Contracted [320492] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv D | $1,116 |
| Imagine 360 Contracted [320494] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv Dec | $1,116 |
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