Emergency visit, moderate (level 3) at Mount St. Mary's Hospital. CPT 99283.

What Mount St. Mary's Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.

Outpatient / ER

$193cash price (self-pay)

$193list price

$24.17–$1,206range insurers pay

Insurance plan	Negotiated rate
Medicare [400001] \| Medicare Railroad [40000104]	$136
Medicare Alternate Payor [888] \| Medicare Part B Alternate [88801]	$136
Medicare [400001] \| Medicare Part B [40000103]	$136
Medicare [400001] \| Medicare Part A And B [40000101]	$136
Excellus Rochester Medicare [450128] \| Excellus Rochester Medicare [45	$136
Medicare Covid Vac Alt [40000101] \| Medicare Covid Vac Alt [4000010102	$136
Seneca Nation [450119] \| Seneca Nation [45011901]	$136
Medicare [400001] \| Medicare Part A [40000102]	$136
No Fault [114001] \| Met Life Auto [11400111]	$162
No Fault [114001] \| No Fault - No Information [11400115]	$162
No Fault [114001] \| Safeco Nf [11500106]	$162
Workers Compensation [500101] \| Em Risk Management [50010105]	$162
Workers Compensation [500101] \| Mac Risk Management [50010106]	$162
WORKERS COMPENSATION [500101] \| New York Black Car Fund [5005004]	$162
WORKERS COMPENSATION [500101] \| PMA Insurance [5005001]	$162
Workers Compensation [500101] \| Special Funds [50010113]	$162
Workers Compensation [500101] \| Workers Comp-Other [50010118]	$162
NO FAULT [114001] \| Hanover Insurance Company [11500107]	$162
No Fault [114001] \| Liberty Mutual Ins [11400108]	$162
No Fault [114001] \| New York Central Mutual [11400102]	$162
NO FAULT [114001] \| The Hartford [11500102]	$162
No Fault [114001] \| Travelers Ins [11400106]	$162
BCBS Medicare [450116] \| Senior Blue Bluesaver [45011603]	$196
Medicare HMO Other [450117] \| Medicare HMO Other [45011701]	$204
Wellcare [450129] \| Wellcare HMO [45012901]	$209
Wellcare Fidelis Dual [450451] \| Wellcare Fidelis Dual Plus [45045101]	$212
Humana Medicare [450130] \| Humana Medicare Pffs [45013002]	$214
BCBS Medicare [450116] \| Anthem Bc Medicare Ooa [45011607]	$219
BCBS Medicare [450116] \| Senior Blue [45011606]	$219
BCBS Community Blue [100173] \| HMO Align Select [10017311]	$274

Inpatient

$193cash price (self-pay)

$193list price

$24.17–$1,206range insurers pay

Insurance plan	Negotiated rate
Independent Health Medicaid [350106] \| Child Health Plus Iha Medicaid	$24.17
Independent Health Medicaid [350106] \| Medisource [35010601]	$24.17
Independent Health Essential [100166] \| Iha Essential Plan 3 And 4 [10	$24.17
Independent Health Medicaid [350106] \| Child Health Plus Iha Non Medic	$24.17
Independent Health Essential [100166] \| Iha Essential Plan 1 And 2 [10	$24.17
Independent Health Essential [100166] \| Independent Health Essential 2	$24.17
Fidelis Essential [100163] \| Fidelis Essential Plan 3 And 4 [10016302]	$60.62
Va Veterans Affairs [700001] \| Va Batavia [70000104]	$67.36
Va Veterans Affairs [700001] \| Va Ccn Optum [70000103]	$67.36
Va Veterans Affairs [700001] \| Va [70000101]	$67.36
Magnacare [100142] \| Magnacare [10014201]	$70.72
Aetna [100001] \| Aetna Other Commercial [10000109]	$70.72
Meritain [100063] \| Meritain [10006301]	$70.72
Aetna [100001] \| Aetna HMO [10000107]	$70.72
Aetna [100001] \| Aetna PPO [10000101]	$70.72
Aetna Medicare HMO [450112] \| Aetna Medicare HMO [45011201]	$70.72
Blue Cross/Blue Shield [100151] \| Empire B/C -Yls [10015107]	$70.81
Blue Cross/Blue Shield [100151] \| Empire B/C PPO-Yls [10015108]	$70.81
Fidelis Essential [100163] \| Fidelis Essential Plan 200-250 [10016303]	$80.83
Fidelis Essential [100163] \| Fidelis Essential Plan 1 And 2 [10016301]	$80.83
Upmc Health Plan [100181] \| Upmc Health Plan [10018101]	$86.47

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