Emergency visit, high (level 4) at Alta Vista Regional Hospital. CPT 99284.
What Alta Vista Regional Hospital publishes for this service, straight from its standard-charges file, last updated April 16, 2026.
Outpatient / ER
$1,106cash price (self-pay)
$2,212list price
$219–$2,212range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial HMO PPO | Western Sky Ambetter | $219 |
| Medicaid HMO | Molina Of TX Mcd | $234 |
| Medicaid Ffs | Az Ffs Medicaid | $234 |
| Medicaid Ffs | Colorado Ffs Medicaid | $234 |
| Medicaid Ffs | Ia Ffs Medicaid | $234 |
| Medicaid Ffs | Wy Ffs Medicaid | $234 |
| Php Centennial | Php Centennial | $234 |
| Medicaid HMO | Turquoise BCBS Mcd | $284 |
| Medicaid HMO | Turquoise Molina Mcd | $284 |
| Medicaid HMO | Turquoise Presb Mcd | $284 |
| Medicaid HMO | Turquoise UHC Mcd | $284 |
| Medicaid HMO | Turquoise Care Mcd | $284 |
| Medicaid Ffs | Medicaid Consultec | $284 |
| Medicaid Ffs | Nm Ffs Medicaid | $284 |
| Commercial HMO PPO | Pres Ind Sel | $284 |
| Commercial HMO PPO | Presby Ind Sel | $284 |
| Medicare HMO | Aetna Medicare Advantage | $310 |
| UHC Advantage | UHC Advantage | $310 |
| Medicare HMO | BCBS Medicare | $319 |
| Medicare | Medicare | $354 |
| Medicare HMO | Molina Medicare Advantage | $354 |
| Misc Medicare Advantage | Misc Medicare Advantage | $354 |
| Medicare HMO | Humana Mcr PPO | $354 |
| Champus | Triwest | $354 |
| Medicare HMO | Aarp UHC Life1 | $354 |
| Medicare HMO | Cigna Medicare Advantage | $354 |
| Medicare HMO | Presby Medicare Adv | $354 |
| Workers Comp | Workers Comp | $907 |
| Self Pay | Self Pay | $1,106 |
| Other Covernment | Nm Behavioral Hlth | $1,383 |
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