Emergency visit, high (level 4) at Kenmore Mercy Hospital. CPT 99284.
What Kenmore Mercy Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$284cash price (self-pay)
$284list price
$40.54–$1,878range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Independent Health Essential [100166] | Independent Health Essential 2 | $45.02 |
| Medicaid Out Of State [309999] | Medicaid Ohio [30999910] | $45.02 |
| Fidelis Medicaid [350105] | Child Health Plus Fidelis Non Medicaid [35 | $103 |
| Fidelis Medicaid [350105] | Fidelis [35010501] | $103 |
| Hospice [550001] | Erie [55000101] | $115 |
| Hospice [550001] | Niagara [55000102] | $115 |
| Seneca Nation [450119] | Seneca Nation [45011901] | $115 |
| Va Veterans Affairs [700001] | Va Batavia [70000104] | $116 |
| INDEPENDENT HEALTH MEDICARE [450122] | IHA Medicare Group [45012205] | $164 |
| Independent Health Medicare [450122] | Mcr Passport Advantage [4501220 | $164 |
| Independent Health [100165] | Iha Encompass [10016503] | $246 |
| Commercial - Other [100172] | Wausau Insurance [10017205] | $616 |
| Boilermakers Natl. Health [100159] | Boilermakers Natl. Health [100159 | $616 |
| Commercial - Other [100172] | Board Of Pensions [10017201] | $616 |
| Commercial - Other [100172] | Guardian [10017203] | $616 |
| Commercial - Other [100172] | Metrahealth [10017208] | $616 |
| Commercial - Other [100172] | Mutual Of Omaha [10017211] | $616 |
| Commercial - Other [100172] | Optum Behavioral Health [10017210] | $616 |
| National Association Of Letter Carriers [100067] | Nalc Health Benefit | $616 |
| Aarp [100007] | Aarp [10000701] | $616 |
| Commercial - Other [100172] | Pomco [10017213] | $616 |
| Commercial - Other [100172] | Upstate Administrative [10017206] | $616 |
| Humana [100052] | Humana PPO [10005202] | $616 |
| Commercial - Other [100172] | Healthy Living Partnershi [10017212] | $616 |
| Commercial - Other [100172] | Tufts Health Plan [10017214] | $616 |
| Humana [100052] | Humana HMO/POS [10005201] | $616 |
| Roofers Local 74 [100155] | Roofers Local 74 [10015501] | $616 |
| Affinity Health Plan [100129] | Affinity Essential Exchange [10012901] | $616 |
| Commercial - Other [100172] | Commercial Other [10017215] | $616 |
| Humana [100052] | Humana One [10005203] | $616 |
Inpatient
$284cash price (self-pay)
$284list price
$40.54–$1,878range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Essential [100152] | Bc Essential Plan 1 And 2 [10015201] | $40.54 |
| BCBS Essential [100152] | Bc Essential Plan 200-250 [10015203] | $40.54 |
| Independent Health Essential [100166] | Iha Essential Plan 3 And 4 [10 | $42.77 |
| Independent Health Medicaid [350106] | Child Health Plus Iha Non Medic | $42.77 |
| Independent Health Essential [100166] | Iha Essential Plan 1 And 2 [10 | $42.77 |
| Independent Health Medicaid [350106] | Child Health Plus Iha Medicaid | $42.77 |
| Aetna [100001] | Aetna Other Commercial [10000109] | $76.47 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 3 And 4 | $83.78 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $83.78 |
| Mvp Essential [100254] | Mvp Essential Plan 3 And 4 [10025402] | $83.87 |
| Mvp Mcd [350114] | Mvp Mcd [35011401] | $83.87 |
| BCBS Medicare [450116] | Medicare PPO B/C [45011601] | $90.39 |
| BCBS Medicare [450116] | Senior Blue Select [45011604] | $90.39 |
| Beacon Essential 1 And 2 Alt [350125] | Beacon Essential 1 And 2 Alt [ | $97.39 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Medicaid Alt [350124 | $97.39 |
| Cigna Medicare HMO [450113] | Cigna Medicare HMO [45011301] | $97.39 |
| Medicare [400001] | Medicare Part A And B [40000101] | $97.39 |
| Medicare HMO Other [450117] | Complete Senior Care [45011704] | $97.39 |
| Tricare [600100] | Usfhp Martins Point Health Care [60010003] | $97.39 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Essential 3 And 4 Al | $97.39 |
| Covid19 Hrsa [45013] | Covid19 Hrsa [4501301] | $97.39 |
| United Healthcare Medicare [450021] | UHC Medicare HMO [45002110] | $98.44 |
| United Healthcare Medicare [450021] | UHC Dual Complete [45002101] | $98.44 |
| United Healthcare Medicare [450021] | UHC Dual Complete Lp Snp 2018 [4 | $98.44 |
| United Healthcare Medicare [450021] | UHC Dual Complete Rppo-Snp [4500 | $98.44 |
| Va Veterans Affairs [700001] | Va Ccn Optum [70000103] | $98.57 |
| Humana Medicare [450130] | Humana Medicare HMO/POS [45013001] | $102 |
| United Healthcare Surest [101154] | United Healthcare Surest [10115401 | $106 |
| United Healthcare Umr [100185] | United Healthcare Umr [10018501] | $106 |
| United Healthcare Alt [100184] | United Healthcare Alt [10018401] | $106 |
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