Emergency visit, high (level 4) at Franciscan Healthcare. CPT 99284.
What Franciscan Healthcare publishes for this service, straight from its standard-charges file, last updated March 18, 2026.
Outpatient / ER
$447cash price (self-pay)
$919list price
$126–$1,334range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica | Medicare Advantage | $369 |
| Humana | Medicare Advantage | $369 |
| Blue Cross Blue Shield of Nebraska | Medicare Advantage | $369 |
| Nebraska Total Care | Medicare Products | $376 |
| Molina Healthcare of Nebraska | Medicare Advantage | $387 |
| Good Samaritan Insurance Plan of Nebraska | Medicare Advantage | $387 |
| Aetna | Medicare Advantage | $387 |
| United Healthcare of the Midlands | Community Plan | $528 |
| Nebraska Total Care | Managed Medicaid | $528 |
| Molina Healthcare of Nebraska | Managed Medicaid/CHIP | $542 |
| United Healthcare | All Commercial Plans | $882 |
| Midlands Choice | All Plans | $882 |
| Aetna Coventry | HMO | $882 |
| Medica | Commercial Products | $1,265 |
| Blue Cross Blue Shield of Nebraska | Blueprint Health | $1,321 |
| Medica | Individual and Family Business Products-Care System Products | $1,334 |
Inpatient
$1,390cash price (self-pay)
$1,390list price
$695–$1,334range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Healthcare of Nebraska | Managed Medicaid/CHIP | $695 |
| Blue Cross Blue Shield of Nebraska | Blueprint Health | $1,321 |
| Aetna Coventry | HMO | $1,334 |
| Midlands Choice | All Plans | $1,334 |
| United Healthcare | All Commercial Plans | $1,334 |
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