Emergency visit, high (level 4) at SBH Health System. CPT 99284.
What SBH Health System publishes for this service, straight from its standard-charges file, last updated February 27, 2026.
Outpatient / ER
$136cash price (self-pay)
$1,885list price
$45.02–$874range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amida Care | Medicaid | $45.02 |
| MetroPlus Health | CHP/HARP/HIV SNP/Medicaid | $94.11 |
| MetroPlus Health | Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliess | $94.11 |
| SOMOS | CHP/HARP/Medicaid | $101 |
| SOMOS | Essential | $101 |
| MetroPlus Health | Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (No | $114 |
| Carelon Behavioral Health | CHP/Medicaid | $120 |
| Healthfirst | CHP/FHP/Medicaid | $133 |
| Healthfirst | Commercial | $134 |
| Healthfirst | Medicare Advantage | $176 |
| Fidelis | Essential Plan Aliesa | $282 |
| Fidelis | CHP/HARP/Medicaid | $295 |
| Fidelis | Essential Plan QHP | $295 |
| Fidelis | Qualified Health Plan | $295 |
| Healthfirst | Essential Plan | $302 |
| Centers Plan For Healthy Living | Dual Advantage/Medicare Advantage/Me | $327 |
| Fidelis | Medicare Advantage | $327 |
| Hamaspik Choice Inc | Medicare | $327 |
| Hamaspik Choice Inc | Medicaid | $327 |
| Healthfirst | QHP | $327 |
| Senior Whole Health | Medicare Advantage | $327 |
| VNS Choice | FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Spec | $327 |
| MetroPlus Health | Commercial/Exchange/Gold Care/Medicare Advantage | $340 |
| Affinity | Essential Plan 1&2 | $364 |
| Affinity | Essential Plan 3&4 | $364 |
| Affinity | Medicaid/CHP/HARP | $364 |
| Aetna | Gatekeeper/Non-Gatekeeper | $520 |
| Aetna | Government | $520 |
| Carelon Behavioral Health | Medicare Advantage | $520 |
| Elderplan | Medicare Advantage | $520 |
Inpatient
—cash price (self-pay)
$1,885list price
$943–$943range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Hamaspik Choice Inc | Medicaid | $943 |
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