Emergency visit, high (level 4) at CHI Health Lakeside. CPT 99284.

What CHI Health Lakeside publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$1,038cash price (self-pay)

$2,472list price

$230–$3,872range insurers pay

Insurance plan	Negotiated rate
Medica \| Commercial\|ACO	$230
Amerigroup \| Medicaid\|All Plans	$347
Centene \| Medicaid\|IA Total Care	$347
IAMolina \| Medicaid\|All Plans	$354
Centene \| Medicaid\|NE Total Care	$396
United \| Medicaid\|Community Plan	$396
BCBS - NE \| Medicare\|All Plans	$415
Humana \| Medicare\|All Plans	$415
Medica \| Medicare\|All Plans	$415
PACE \| Medicare\|All Plans	$415
United \| Medicare\|All Plans	$415
Todays Options \| Medicare\|All Plans	$423
Centene \| Medicare\|All Plans	$427
Amerigroup \| Medicare\|All Plans	$436
Great Plains \| Medicare\|All Plans	$436
ELAP \| Commercial\|All Plans	$692
Medica \| Commercial\|CHI Health	$768
AMPS \| Commercial\|All Plans	$921
Medica \| Commercial\|All Other Plans	$1,047
Medica \| Commercial\|Open Access	$1,285
Midlands Choice \| Commercial\|Premier	$1,285
QuikTrip \| Commercial\|All Plans	$1,483
Midlands Choice \| Commercial\|Standard	$1,854
PHCS \| Commercial\|All Plans	$1,854
MultiPlan \| Commercial\|All Plans	$2,101
Creighton University Employees \| Commercial\|All Plans	$2,753
United \| Commercial\|All Plans	$3,337
Greater Omaha Packing \| Commercial\|Narrow Network	$3,367
Millard Public Schools \| Commercial\|Narrow Network	$3,367
One World \| Commercial\|Narrow Network	$3,367

$1,038cash price (self-pay)

$2,472list price

$1,483–$2,101range insurers pay

Insurance plan	Negotiated rate
QuikTrip \| Commercial\|All Plans	$1,483
PHCS \| Commercial\|All Plans	$1,755
MultiPlan \| Commercial\|All Plans	$2,101

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