Emergency visit, high (level 4) at Franklin Country Memorial Hospital. CPT 99284.
What Franklin Country Memorial Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$273cash price (self-pay)
$590list price
$104–$833range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Midlands Choice | PPO | $218 |
| United Healthcare | PPO | $415 |
| United Healthcare | Commercial | $415 |
| United Healthcare | HMO | $415 |
| Aetna | Medicare Advantage | $437 |
| Aetna | Commercial | $561 |
| Blue Cross Blue Shield of Nebraska | PPO | $561 |
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