Emergency visit, moderate (level 3) at CHI Health St. Mary's. CPT 99283.
What CHI Health St. Mary's publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$168cash price (self-pay)
$428list price
$43.27–$628range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid|All Plans | $91.68 |
| IAMolina | Medicaid|All Plans | $93.48 |
| BCBS - NE | Medicare|All Plans | $156 |
| Humana | Medicare|All Plans | $156 |
| Medica | Medicare|All Plans | $156 |
| PACE | Medicare|All Plans | $156 |
| United | Medicare|All Plans | $156 |
| Centene | Medicare|All Plans | $159 |
| Amerigroup | Medicare|All Plans | $164 |
| Great Plains | Medicare|All Plans | $164 |
| Centene | Medicaid|NE Total Care | $175 |
| United | Medicaid|Community Plan | $175 |
| AMPS | Commercial|All Plans | $346 |
| BCBS - NE | Commercial|BluePrint | $386 |
| Medica | Commercial|All Other Plans | $389 |
| Medica | Commercial|CHI Health | $389 |
| BCBS - NE | Commercial|All Other Plans | $407 |
| MultiPlan PHCS | Commercial|All Plans | $407 |
| Greater Omaha Packing | Commercial|Broad Network | $411 |
| Greater Omaha Packing | Commercial|Narrow Network | $411 |
| Medica | Commercial|ACO | $411 |
| Medica | Commercial|Open Access | $411 |
| Midlands Choice | Commercial|Premier | $411 |
| Midlands Choice | Commercial|Standard | $411 |
| Millard Public Schools | Commercial|Broad Network | $411 |
| Millard Public Schools | Commercial|Narrow Network | $411 |
| One World | Commercial|Broad Network | $411 |
| One World | Commercial|Narrow Network | $411 |
| Timpte | Commercial|Broad Network | $411 |
| United | Commercial|All Plans | $411 |
Inpatient
$168cash price (self-pay)
$428list price
$182–$628range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS - NE | Commercial|BluePrint | $386 |
| Medica | Commercial|All Other Plans | $389 |
| Medica | Commercial|CHI Health | $389 |
| BCBS - NE | Commercial|All Other Plans | $407 |
| MultiPlan PHCS | Commercial|All Plans | $407 |
| Greater Omaha Packing | Commercial|Broad Network | $411 |
| Greater Omaha Packing | Commercial|Narrow Network | $411 |
| Medica | Commercial|ACO | $411 |
| Medica | Commercial|Open Access | $411 |
| Midlands Choice | Commercial|Premier | $411 |
| Midlands Choice | Commercial|Standard | $411 |
| Millard Public Schools | Commercial|Broad Network | $411 |
| Millard Public Schools | Commercial|Narrow Network | $411 |
| One World | Commercial|Broad Network | $411 |
| One World | Commercial|Narrow Network | $411 |
| Timpte | Commercial|Broad Network | $411 |
| United | Commercial|All Plans | $411 |
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