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

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

Outpatient / ER

$632cash price (self-pay)

$1,264list price

$230–$4,326range insurers pay

Insurance plan	Negotiated rate
Medica \| Commercial\|ACO	$230
United \| Medicaid\|Community Plan	$291
Centene \| Medicaid\|NE Total Care	$294
Amerigroup \| Medicaid\|All Plans	$347
Centene \| Medicaid\|IA Total Care	$347
IAMolina \| Medicaid\|All Plans	$354
BCBS - NE \| Medicare\|All Plans	$411
Great Plains \| Medicare\|All Plans	$411
Humana \| Medicare\|All Plans	$411
Medica \| Medicare\|All Plans	$411
United \| Medicare\|All Plans	$411
Centene \| Medicare\|All Plans	$423
Amerigroup \| Medicare\|All Plans	$432
ELAP \| Commercial\|All Plans	$720
Medica \| Commercial\|Open Access	$784
Midlands Choice \| Commercial\|Premier	$784
Midlands Choice \| Commercial\|Standard	$872
AMPS \| Commercial\|All Plans	$912
Medica \| Commercial\|CHI Health	$1,035
MultiPlan PHCS \| Commercial\|All Plans	$1,074
Medica \| Commercial\|All Other Plans	$1,215
Creighton University Employees \| Commercial\|All Plans	$1,900
United \| Commercial\|All Plans	$2,260
Greater Omaha Packing \| Commercial\|Narrow Network	$3,762
Millard Public Schools \| Commercial\|Narrow Network	$3,762
One World \| Commercial\|Narrow Network	$3,762
Greater Omaha Packing \| Commercial\|Broad Network	$4,326
Millard Public Schools \| Commercial\|Broad Network	$4,326
One World \| Commercial\|Broad Network	$4,326
Timpte \| Commercial\|Broad Network	$4,326

$632cash price (self-pay)

$1,264list price

$784–$1,011range insurers pay

Insurance plan	Negotiated rate
Medica \| Commercial\|Open Access	$784
Midlands Choice \| Commercial\|Premier	$784
MultiPlan PHCS \| Commercial\|All Plans	$1,011

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