Emergency visit, high (level 4) at Holy Rosary Healthcare. CPT 99284.
What Holy Rosary Healthcare publishes for this service, straight from its standard-charges file, last updated March 22, 2026.
Outpatient / ER
—cash price (self-pay)
$1,152list price
$191–$1,126range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Allegiance | Allegiance Mmia | $530 |
| Tire Rama | Tire Rama | $530 |
| Pacificsource | Pacificsource Smart Health/Nav Network | $568 |
| Ebms-Employee Benefit Mng | Ebms - Employee Benefit | $586 |
| First Choice Health | Boon-Chapman | $586 |
| First Choice Health | First Choice Health | $586 |
| First Choice Health | First Choice Other | $586 |
| First Choice Health | Healthcomp Tpa | $586 |
| Allegiance | Allegiance Group Health | $597 |
| Allegiance | Allegiance Other | $597 |
| Allegiance | Cigna - Commercial | $597 |
| Allegiance | Cigna Sclhs Employees | $597 |
| Allegiance | Silver Bow County Employees | $597 |
| Cigna | Cigna Other | $597 |
| Cigna | Cigna POS/Qpos | $597 |
| Cigna | Cigna PPO | $597 |
| Cigna | Eighth Dist Elect Ben Pln | $597 |
| Meritain Health | Meritain Health | $610 |
| Mt Health Co-Op | Mountain Health Co-Op | $612 |
| Pacificsource | Pacificsource Voyager Network | $619 |
| Geha | Geha | $633 |
| United Healthcare | Golden Rule Ins | $633 |
| United Healthcare | UHC Charter/Navigate | $633 |
| United Healthcare | UHC Exchange Plan | $633 |
| United Healthcare | UHC Other/Supplemental | $633 |
| United Healthcare | Umr-United Med Resources | $633 |
| United Healthcare | United Healthcare | $633 |
| Aetna | Aetna HMO/EPO | $1,037 |
| Aetna | Aetna POS/Qpos | $1,037 |
| Aetna | Aetna PPO | $1,037 |
Inpatient
—cash price (self-pay)
$1,152list price
$922–$1,126range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Pacificsource | Pacificsource Smart Health/Nav Network | $922 |
| Ebms-Employee Benefit Mng | Ebms - Employee Benefit | $979 |
| First Choice Health | Boon-Chapman | $979 |
| First Choice Health | First Choice Health | $979 |
| First Choice Health | First Choice Other | $979 |
| First Choice Health | Healthcomp Tpa | $979 |
| Allegiance | Allegiance Group Health | $1,002 |
| Allegiance | Allegiance Other | $1,002 |
| Allegiance | Cigna - Commercial | $1,002 |
| Allegiance | Cigna Sclhs Employees | $1,002 |
| Allegiance | Silver Bow County Employees | $1,002 |
| Cigna | Cigna Other | $1,002 |
| Cigna | Cigna POS/Qpos | $1,002 |
| Cigna | Cigna PPO | $1,002 |
| Cigna | Eighth Dist Elect Ben Pln | $1,002 |
| Mt Health Co-Op | Mountain Health Co-Op | $1,014 |
| Meritain Health | Meritain Health | $1,025 |
| Pacificsource | Pacificsource Voyager Network | $1,025 |
| Aetna | Aetna HMO/EPO | $1,037 |
| Aetna | Aetna POS/Qpos | $1,037 |
| Aetna | Aetna PPO | $1,037 |
| Multiplan Inc | Multiplan Inc Other | $1,037 |
| Multiplan Inc | Multiplan Inc PPO | $1,037 |
| BCBS/Anthem | BCBS Mt - Federal | $1,037 |
| BCBS/Anthem | BCBS Mt POS | $1,037 |
| BCBS/Anthem | BCBS Mt POS Exchange | $1,037 |
| Geha | Geha | $1,060 |
| United Healthcare | Golden Rule Ins | $1,060 |
| United Healthcare | UHC Charter/Navigate | $1,060 |
| United Healthcare | UHC Exchange Plan | $1,060 |
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