Emergency visit, high (level 4) at Sanford Medical Center Mayville. CPT 99284.
What Sanford Medical Center Mayville publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$958cash price (self-pay)
$1,197list price
$290–$1,112range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $290 |
| Sanford Health Plan Align | Medicare Replacement | $591 |
| Ucare | Medicare Replacement | $634 |
| Aetna | Medicare Replacement | $642 |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $642 |
| Great Plains Medicare Advantage | Medicare Replacement | $642 |
| Health Partners | Medicare Replacement | $642 |
| United Healthcare | Medicare Replacement | $642 |
| Primewest | Medicare Replacement | $654 |
| Security Health Plan | Commercial | $658 |
| Blue Cross Blue Shield of North Dakota | Commercial | $811 |
| Health Partners | Commercial | $934 |
| Sanford Health Plan | Group Health/True/SD Exchange True | $945 |
| Medica | Choice | $988 |
| United Healthcare | Commercial | $1,000 |
| Aetna | Commercial | $1,040 |
| Ucare | Commercial | $1,052 |
| Medica | Elect | $1,056 |
| First Choice Health Network | Commercial | $1,077 |
| Healthez | Commercial | $1,077 |
| Multiplan | Commercial | $1,077 |
| Blue Cross Blue Shield of Minnesota | Commercial | $1,107 |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $1,112 |
Inpatient
$958cash price (self-pay)
$1,197list price
$658–$1,112range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Security Health Plan | Commercial | $658 |
| Health Partners | Commercial | $934 |
| Sanford Health Plan | Group Health/True/SD Exchange True | $945 |
| Medica | Choice | $988 |
| United Healthcare | Commercial | $1,000 |
| Aetna | Commercial | $1,040 |
| Ucare | Commercial | $1,052 |
| Medica | Elect | $1,056 |
| First Choice Health Network | Commercial | $1,077 |
| Healthez | Commercial | $1,077 |
| Multiplan | Commercial | $1,077 |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $1,112 |
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