Emergency visit, high (level 4) at Mercy Hospital Lebanon. CPT 99284.
What Mercy Hospital Lebanon publishes for this service, straight from its standard-charges file, last updated June 10, 2026.
Outpatient / ER
$1,278cash price (self-pay)
$3,302list price
$105–$7,321range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Health Medicare Contracted [320500] | Hb Lebn Devoted Health M | $183 |
| Wellcare Medicare Advantage Contracted [320421] | Hb Sprg & Lebn Wellc | $423 |
| Nhc Advantage Medicare Contracted [320282] | Hb Sprg Nhc Advantage Mcr | $431 |
| Provider Partners Health Plans Contracted [320450] | Hb Lebn Medicare | $439 |
| Kindful Hospice Contracted [320434] | Hb Lebn Medicare | $439 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Lebn Med | $439 |
| Halo Hcr Inc Hospice Contracted [320432] | Hb Lebn Medicare | $439 |
| Mercy Mgd Behavioral Health Contracted [320259] | Hb Lebn Medicare | $439 |
| Tricare Contracted [320380] | Hb Lebn Tricare | $439 |
| Qual Choice Contracted [320325] | Hb Lebn Medicare | $439 |
| United Healthcare Contracted [320396] | Hb Lebn Medicare | $439 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Leb | $439 |
| Medica Medicare Advantage Contracted [320477] | Hb Lebn Medicare | $439 |
| Pace Of The Ozarks Contracted [320518] | Hb Lebn Medicare | $439 |
| Acentra Health Contracted [320527] | Hb Lebn Medicare | $439 |
| Healthspring Medicare Advantage Contracted [320526] | Hb Lebn Medicare | $439 |
| Globalhealth Contracted [320145] | Hb Lebn Medicare | $439 |
| HUMANA MEDICARE ADVANTAGE CONTRACTED [320194] | HB LEBN HUMANA MCR New | $439 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Lebn Medicare | $439 |
| Aetna Medicare Advantage Contracted [320010] | Hb Lebn Medicare | $439 |
| BCBS Medicare Advantage Contracted [320047] | Hb Lebn Medicare | $439 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Lebn Medicare | $439 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Lebn Medicare | $439 |
| Healthscope Contracted [320182] | Hb Lebn Dec Orscheln Mcr 125% | $560 |
| Centivo Contracted [320505] | Hb Lebn Centivo 165% Medicare | $739 |
| Novasys Contracted [320285] | Hb Lebn Ambetter Exchange Mo | $1,193 |
| Sunflower Health Plan Contracted [320369] | Hb Lebn Ambetter Exchange | $1,193 |
| Ambetter Contracted [320452] | Hb Lebn Ambetter Exchange Mo | $1,193 |
| Home State Health Plan Contracted [320187] | Hb Lebn Ambetter Exchange | $1,193 |
| Medica Contracted [320239] | Hb Sprg Lebn Medica Exchange | $1,525 |
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