Emergency visit, highest (level 5) at Good Samaritan University Hospital. CPT 99285.
What Good Samaritan University Hospital publishes for this service, straight from its standard-charges file, last updated February 19, 2026.
Outpatient / ER
—cash price (self-pay)
$3,049list price
$304–$3,049range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS-NY Empire | MA | $711 |
| Aetna | Medicare | $726 |
| Centerlight Healthcare | PACE | $726 |
| Centers Plan For Healthy Living | Medicare | $726 |
| Elderplan Inc. | MA | $726 |
| Emblem Health | Medicare HMO | $726 |
| Fidelis Care New York | DUAL | $726 |
| Fidelis Care New York | MA | $726 |
| Fidelis Care New York | MLTC | $726 |
| Agewell New York | Medicare HMO | $751 |
| Brighton | LOCAL 3 MAGNA JIB | $1,641 |
| Centivo | Commercial | $1,755 |
| Brighton | Direct Plus | $1,888 |
| Brighton | PPO | $1,888 |
| BCBS-NY Empire | Blue Access Small Group | $1,929 |
| Aetna | Narrow Network | $1,962 |
| Allied Wellfare Fund | Commercial | $1,982 |
| American Group Administrators | Commercial | $1,982 |
| Bakery & Confectionery Union | Commercial | $1,982 |
| Cigna | Indemnity | $1,982 |
| Comprehensive Benefits Consultant | Commercial | $1,982 |
| APWU | Commercial | $2,186 |
| Centivo | PPO Cigna Medical | $2,186 |
| Cigna | Commercial | $2,186 |
| Daniel H Cook | Associates | $2,186 |
| Coventry | HMO | $2,256 |
| BCBS-NY Empire | Blue Access Large Group | $2,285 |
| Aetna | Commercial | $2,335 |
| BCBS-NY Empire | Commercial | $2,538 |
| Coventry | First Health PPO | $2,592 |
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