Emergency visit, high (level 4) at Mercy Hospital Perry. CPT 99284.
What Mercy Hospital Perry publishes for this service, straight from its standard-charges file, last updated March 12, 2026.
Outpatient / ER
$241cash price (self-pay)
$772list price
$55.50–$6,620range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid [20240] | Hb Wash Jefn Linc Samc Pcmh Stod IL Medicaid | $65.25 |
| Medicare [20244] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $132 |
| Mercy Hospice Okc [20252] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $132 |
| Kindful Hospice [20434] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1% | $132 |
| Elara Caring Aspire Hospice [20433] | Hb Pcmh Medicare/Managed Mcr W/S | $132 |
| Halo Hcr Inc Hospice [20432] | Hb Pcmh Medicare/Managed Mcr W/Seq 98.1 | $132 |
| Blue Cross And Blue Shield [20053] | Hb Pcmh Medicare/Managed Mcr W/Se | $132 |
| BCBS Medicare Advantage [20047] | Hb Pcmh Medicare/Managed Mcr W/Seq 9 | $132 |
| Cross Timbers Hospice [20098] | Hb Pcmh Medicare/Managed Mcr W/Seq 98. | $132 |
| Humana Medicare Advantage [20194] | Hb Pcmh Medicare/Managed Mcr W/Seq | $132 |
| Aetna Medicare Advantage Contracted [320010] | Hb Pcmh Aetna/Coventry | $138 |
| Ambetter [20452] | Hb Pcmh Ambetter Exchange | $206 |
| Blue Cross And Blue Shield [20053] | Hb Stlo Wash Jefn Linc Samc Cape | $207 |
| Aetna Contracted [320008] | Hb Pcmh Linc Aetna Coventry All Products | $285 |
| Aetna [20008] | Hb Pcmh Linc Aetna Coventry All Products | $285 |
| First Health [20128] | Hb Pcmh Linc Aetna Coventry All Products | $285 |
| Aither Health [20449] | Hb Linc Pcmh Shine Solar Dec New 110320 | $370 |
| Mercy Benefit Admin [20251] | Hb Linc Pcmh Clayco Dec | $370 |
| Mercy Benefit Admin [20251] | Hb Linc Pcmh Hermann Area District Hospi | $370 |
| Mercy Benefit Admin [20251] | Hb Linc Pcmh Schaefer Autobody Dec New 0 | $370 |
| Mercy Benefit Admin [20251] | Hb Linc Pcmh Dec Show Me Consortium New | $370 |
| Mercy Benefit Admin [20251] | Hb Linc Pcmh Dec Eba - Employer Benefit | $370 |
| Mercy Benefit Admin Contracted [320251] | Hb Linc Pcmh Dec Eba - Emplo | $370 |
| Mo Medicaid Bh Carve Out [320315] | Hb Pcmh Mo Medicaid | $508 |
| Medicaid Pending [20241] | Hb Pcmh Missouri Care Health Plan/Healthy B | $508 |
| Medicaid [20240] | Hb Pcmh Mo Medicaid | $508 |
| BCBS Medicaid Contracted [320046] | Hb Pcmh Missouri Care Health Plan/ | $508 |
| Medicaid Pending [20241] | Hb Pcmh Home State Managed Medicaid | $549 |
| Home State Medicaid Contracted [320189] | Hb Pcmh Home State Managed M | $549 |
| United Healthcare Medicaid Contracted [320397] | Hb Pcmh UHC Managed M | $559 |
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