Emergency visit, high (level 4) at Roosevelt Medical Center. CPT 99284.
What Roosevelt Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$253cash price (self-pay)
$709list price
$143–$1,164range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UnitedHeathcare | PPO | $619 |
| Blue Cross Blue Sheild | PPO | $632 |
| Three Rivers Provider Network | TRPN workers Comp | $638 |
| PacificSource | PPO | $654 |
| Allegiance | PPO | $655 |
| Mountain Health Co-op | PPO/POS | $666 |
| Blue Cross Blue Shield | Traditional | $667 |
| EBMS | SelectCare Network | $676 |
| Interwest | PPO | $679 |
| Interwest | Traditional Network | $685 |
| Three Rivers Provider Network | TRPN commercial plans | $694 |
| First Choice Health Network | Standard/Equitable Plans | $844 |
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