Emergency visit, high (level 4) at St. Mary's General Hospital. CPT 99284.
What St. Mary's General Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$493cash price (self-pay)
$2,099list price
$138–$1,679range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC - Adhoc | UHC - Adhoc Oxford | $138 |
| Horizon | Horizon NJ Health Medicaid | $140 |
| UHC | UHC Medicaid (02/01/2023 to 12-31-2026) | $140 |
| Wellpoint Amerigroup | Wellpoint Amerigroup Medicaid | $140 |
| Wellchoice | WELLCHOICE HMO of NJ (Empire) Commercial (HMO / HMO POS, | $337 |
| Wellchoice | WELLCHOICE HMO of NJ (Empire) Commercial (Indemnity) | $369 |
| Humana | Humana Military Tricare | $395 |
| Horizon | Horizon Medicare | $493 |
| Traditional Medicare | Traditional Medicare | $493 |
| Tricare | Tricare | $493 |
| Wellcare | Wellcare Medicare | $493 |
| Wellpoint Amerigroup | Wellpoint Amerigroup Medicare | $493 |
| Aetna | Aetna Medicare | $493 |
| Americhoice (UHC) | UHC Medicare | $493 |
| Amerihealth | Amerihealth Medicare | $493 |
| Clover Health | Clover Medicare | $493 |
| Ally-Align (Fka Spartan Plan Nj, Inc.) | Ally-Align (Fka Spartan Plan | $518 |
| Wellcare | Wellcare Insurance Exchange | $666 |
| Employer Direct Healthcare | Employer Direct Healthcare | $691 |
| Cigna | Cigna Commercial | $725 |
| Horizon | Horizon Casualty Services Personal Injury Protection - PIP | $764 |
| Horizon | Horizon Casualty Services Workers Compensation | $764 |
| Fairprice Healthcare Holdings | Fairprice Healthcare Holdings | $789 |
| Horizon | Horizon BCBS Of NJ HMO POS | $875 |
| Horizon | Horizon BCBS Of NJ Indemnity | $875 |
| Horizon | Horizon BCBS Of NJ PPO | $875 |
| Coventry | Coventry Auto | $987 |
| Coventry | Coventry Workers Compensation | $987 |
| Aetna | Aetna Commercial | $1,046 |
| Aetna | Aetna Medical Rental Network | $1,046 |
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