Emergency visit, high (level 4) at Alice Hyde Medical Center. CPT 99284.
What Alice Hyde Medical Center publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$439cash price (self-pay)
$439list price
$82.48–$2,545range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Capital District Physicians' Health Plan | Essential Plans | $82.48 |
| Capital District Physicians' Health Plan | Managed Medicaid | $82.48 |
| United Healthcare | Managed Medicaid/Essential Plans | $84.74 |
| Fidelis Care | Child Health Plus | $96.04 |
| MVP | Essential Plans | $96.04 |
| MVP | Managed Medicaid | $96.04 |
| Fidelis Care | Managed Medicaid | $113 |
| Fidelis Care | Essential Plans | $119 |
| Fidelis Care | Health Benefit Exchange Products | $124 |
| Excellus BlueCross BlueShield | Managed Medicaid/Essential Plans | $160 |
| Humana Military | TRICARE | $198 |
| United Healthcare Empire Plan | Commercial PPO for NY State Employees | $200 |
| Aetna | Medicare Advantage | $207 |
| Capital District Physicians' Health Plan | Medicare Advantage | $207 |
| Martins Point | TRICARE Prime/Department of Defense | $207 |
| MVP | Medicare Advantage | $207 |
| United Healthcare | Medicare Advantage | $207 |
| Veterans Affairs Community Care Network | Veterans Administration | $207 |
| ChoiceCare | Medicare Advantage | $209 |
| Excellus BlueCross BlueShield | Medicare Advantage | $210 |
| Fidelis Care | Medicare Advantage | $215 |
| St. Regis | HMO | $271 |
| ChoiceCare | Commercial | $429 |
| Aetna | Commercial | $488 |
| MVP | Individual Group Commercial | $529 |
| Capital District Physicians' Health Plan | Commercial | $533 |
| MagnaCare | Commercial | $552 |
| Highmark BlueShield | IND/FEP/PPO/HMO | $636 |
| MVP | Small/Large Group Commercial | $646 |
| Excellus BlueCross BlueShield | Commercial | $761 |
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