Emergency visit, moderate (level 3) at Tri Valley Health System. CPT 99283.
What Tri Valley Health System publishes for this service, straight from its standard-charges file, last updated October 2, 2026.
Outpatient / ER
$300cash price (self-pay)
$333list price
$64.60–$711range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Nebraska Total Care-All Plans | Nebraska Total Care-All Plans | $160 |
| Healthy Blue Mcaid - All Plans | Healthy Blue Mcaid - All Plans | $160 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $160 |
| UHC Comm Plan Mcaid | UHC Comm Plan Mcaid | $160 |
| Amerigroup Mcaid - All Plans | Amerigroup Mcaid - All Plans | $163 |
| Medica Chi Aco - All Other Plans | Medica Chi Aco - All Other Plans | $300 |
| Medica Ifb Open Access | Medica Ifb Open Access | $300 |
| Medica Chi Open Access | Medica Chi Open Access | $300 |
| Medica Ifb Aco | Medica Ifb Aco | $300 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $300 |
| BCBS Blue Print | BCBS Blue Print | $303 |
| BCBS - All Other Plans | BCBS - All Other Plans | $316 |
| BCBS Mcr Adv | BCBS Mcr Adv | $319 |
| Medica Prime Sol | Medica Prime Sol | $319 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $319 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $319 |
| Medica Mcr Adv | Medica Mcr Adv | $319 |
| Tricare - All Plans | Tricare - All Plans | $319 |
| UHC Comm -All Other Plans | UHC Comm -All Other Plans | $320 |
| Aetna Employer | Aetna Employer | $326 |
| Aetna PPO/HMO - All Other Plans | Aetna PPO/HMO - All Other Plans | $326 |
| Aetna Advantra HMO | Aetna Advantra HMO | $326 |
| Multiplan-All Plans | Multiplan-All Plans | $326 |
| Great Plains Mcr Adv - All Plans | Great Plains Mcr Adv - All Plans | $335 |
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