Emergency visit, highest (level 5) at Samaritan Hospital. CPT 99285.
What Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$367cash price (self-pay)
$367list price
$111–$4,109range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross - NY (Anthem) Medicare Advantage | Empire BCBS Medicare Adv | $729 |
| Medigold Medicare Advantage | Medigold Medicare Advantage | $743 |
| Mvp Medicare Advantage | Mvp Medicare Advantage | $743 |
| Eddy Seniorcare Pace | Eddy Senior Care | $743 |
| Capital District Physicians Health Plan Medicare Advantage | Cdphp Med | $743 |
| Secure Horizons MA Pffs | United Healthcare Medicare Advantage | $758 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $758 |
| Hudson Headwaters Pace | Hudson Headwaters Pace | $803 |
| Wellcare Medicare | Wellcare Medicare Advantage | $813 |
| Fidelis Medicare | Fidelis Medicare Advantage | $813 |
| Blue Shield - NY Highmark Northeastern Medicare Advantage | Blue Shiel | $818 |
| Blue Cross - NY (Excellus) Medicare Advantage | Blue Shield Of Ne New | $818 |
| Emblem Health Medicare Advantage | Emblem Medicare Advantage | $831 |
| Nascentia Health Plus | Nascentia Health Plus Medicare Advantage | $833 |
| Blue Cross - NY (Anthem) | Empire BCBS Blue Access | $1,537 |
| Blue Cross - Me (Anthem) | Empire BCBS HMO EPO PPO Indemnity | $1,711 |
| Blue Cross - Sd (Wellmark) | Empire BCBS HMO EPO PPO Indemnity | $1,711 |
| Blue Cross - Oh (Anthem) | Empire BCBS HMO EPO PPO Indemnity | $1,711 |
| Blue Cross - NY (Anthem) | Empire BCBS HMO EPO PPO Indemnity | $1,711 |
| Blue Cross - Ia (Wellmark) | Blue Shield Of Ne New York HMO | $1,732 |
| Blue Cross - Nj (Horizon) | Blue Shield Of Ne New York HMO | $1,732 |
| Blue Cross - IL | Blue Shield Of Ne New York HMO | $1,732 |
| Capital District Physicians Health Plan | Cdphp | $1,982 |
| United Healthcare | United Healthcare | $2,022 |
| Blue Cross - Ks | Blue Shield Of Ne New York PPO | $2,165 |
| Blue Cross - Ia (Wellmark) | Blue Shield Of Ne New York PPO | $2,165 |
| Blue Cross - Mt | Blue Shield Of Ne New York PPO | $2,165 |
| Blue Cross - Al | Blue Shield Of Ne New York PPO | $2,165 |
| Blue Cross - Ne | Blue Shield Of Ne New York PPO | $2,165 |
| Blue Cross - Az | Blue Shield Of Ne New York PPO | $2,165 |
Inpatient
$450cash price (self-pay)
$450list price
$111–$450range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Pace Of Southwest Michigan | Pb Xr 100% Default | $450 |
| Union Health Service | Pb Xr 100% Default | $450 |
| Molina Medicare Advantage | Pb Xr 100% Default | $450 |
| Dentaquest | Pb Xr 100% Default | $450 |
| Rx Allwin | Pb Xr 100% Default | $450 |
| Harvard Pilgrim Healthcare | Pb Xr 100% Default | $450 |
| The Health Plan | Pb Xr 100% Default | $450 |
| Health Choices | Pb Xr 100% Default | $450 |
| Commonwealth Care Alliance | Pb Xr 100% Default | $450 |
| Everence | Pb Xr 100% Default | $450 |
| Wc Key Ins & Benefit Solutions | Pb Xr 100% Default | $450 |
| Dean Wi Badgercare | Pb Xr 100% Default | $450 |
| Rx Value Rx | Pb Xr 100% Default | $450 |
| Wc Mercy Workcare | Pb Xr 100% Default | $450 |
| Rx Script Card | Pb Xr 100% Default | $450 |
| Ghc Scw Wi Badgercare | Pb Xr 100% Default | $450 |
| Wc Tristar | Pb Xr 100% Default | $450 |
| Rx Perform | Pb Xr 100% Default | $450 |
| Care Wisconsin Medicaid | Pb Xr 100% Default | $450 |
| Wc Tyson | Pb Xr 100% Default | $450 |
| Rx Amerisource | Pb Xr 100% Default | $450 |
| Wellpoint Medicaid | Pb Xr 100% Default | $450 |
| Wc Winnebago Industries | Pb Xr 100% Default | $450 |
| Wc Compone Admin | Pb Xr 100% Default | $450 |
| Rx Security Health | Pb Xr 100% Default | $450 |
| Wc Benetech | Pb Xr 100% Default | $450 |
| Wc Fed Ex | Pb Xr 100% Default | $450 |
| Rx Mrx | Pb Xr 100% Default | $450 |
| Wc Corvel | Pb Xr 100% Default | $450 |
| Rx Shp | Pb Xr 100% Default | $450 |
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