Emergency visit, high (level 4) at Champlain Valley Physicians Hospital. CPT 99284.
What Champlain Valley Physicians Hospital publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$301cash price (self-pay)
$301list price
$84.74–$286range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | Managed Medicaid/Essential Plans | $84.74 |
| Excellus BlueCross BlueShield | Managed Medicaid/Essential Plans | $93.60 |
| MVP | Essential Plans | $96.04 |
| MVP | Managed Medicaid | $96.04 |
| Aetna | Medicare Advantage | $113 |
| Capital District Physicians' Health Plan | Essential Plans | $113 |
| Capital District Physicians' Health Plan | Managed Medicaid | $113 |
| Capital District Physicians' Health Plan | Medicare Advantage | $113 |
| Empire BlueCross BlueShield | Managed Medicaid Aliessa | $113 |
| Empire BlueCross BlueShield | Medicare Advantage | $113 |
| Excellus BlueCross BlueShield | Medicare Advantage | $113 |
| Fidelis Care | Managed Medicaid | $113 |
| Fidelis Care | Medicare Advantage | $113 |
| Humana Military | TRICARE | $113 |
| United Healthcare | Medicare Advantage | $113 |
| Veterans Affairs Community Care Network | Veterans Administration | $113 |
| Martins Point | TRICARE Prime/Department of Defense | $113 |
| MVP | Medicare Advantage | $115 |
| Fidelis Care | Essential Plans | $119 |
| Empire BlueCross BlueShield | Essential Plans/Managed Medicaid | $136 |
| Excellus BlueCross BlueShield | Commercial | $145 |
| Highmark BlueShield | IND/FEP | $145 |
| Highmark BlueShield | PPO/HMO | $145 |
| Wellpath | FCI Ray Brook | $158 |
| Aetna | Commercial | $166 |
| Empire BlueCross BlueShield | Individual Network | $181 |
| Capital District Physicians' Health Plan | Commercial | $184 |
| MVP | Commercial | $215 |
| United Healthcare Empire Plan | Commercial PPO for NY State Employees | $217 |
| Empire BlueCross BlueShield | Blue Access | $224 |
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