Emergency visit, high (level 4) at Faith Regional Health Services. CPT 99284.
What Faith Regional Health Services publishes for this service, straight from its standard-charges file, last updated September 3, 2026.
Outpatient / ER
$767cash price (self-pay)
$1,314list price
$462–$508range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $462 |
| Blue Cross Blue Shield of NE | Medicare Advantage | $462 |
| Ambetter | Medicare Advantage | $476 |
| United Healthcare | Medicare Advantage | $476 |
| Wellcare | Medicare Advantage | $476 |
| Good Samaritan Insurance Plan | Medicare Advantage | $485 |
| Great Plains | Medicare Advantage | $485 |
| Medica | Medicare Advantage | $485 |
| Molina | Medicare Advantage | $508 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.