Emergency visit, high (level 4) at UPMC Chautauqua. CPT 99284.
What UPMC Chautauqua publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$415cash price (self-pay)
$692list price
$119–$1,248range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Health Plan | CHIP | $119 |
| UPMC Health Plan | Managed Medicaid | $119 |
| Geisinger | Medicaid/CHIP | $133 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $144 |
| UNITED BEHAVIORAL HEALTH | Medicaid | $144 |
| MagnaCare | No Fault | $222 |
| MagnaCare | Workers Compensation | $222 |
| Univera | Essential Plan | $241 |
| UPMC Health Plan | Commercial | $415 |
| United Healthcare | Commercial | $443 |
| Aetna | Commercial | $450 |
| MagnaCare | Direct Plus | $519 |
| MagnaCare | PPO | $519 |
| Multiplan | PPO (Includes PHCS as a Payer) | $519 |
| Beacon | Medicare Advantage | $520 |
| Humana | Medicare | $520 |
| United Healthcare | Medicare | $520 |
| United Behavioral Health | Medicare | $520 |
| Fidelis | Medicare | $520 |
| UPMC Health Plan | Managed Medicare | $520 |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $531 |
| Wellcare | Medicare | $536 |
| Aetna | Medicare | $541 |
| GHI/Emblem Health | Commercial | $554 |
| Humana | Commercial | $554 |
| Statewide Independent PPO | PPO | $609 |
| Univera | Medicare Advantage | $619 |
| Affordable First Health | PPO | $623 |
| Beacon | Commercial | $650 |
| BCBS of Western NY | Medicaid | $652 |
Inpatient
$415cash price (self-pay)
$692list price
$450–$519range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Commercial | $450 |
| United Healthcare | Commercial | $450 |
| Humana | Commercial | $519 |
| MagnaCare | Direct Plus | $519 |
| MagnaCare | PPO | $519 |
| MagnaCare | No Fault | $519 |
| MagnaCare | Workers Compensation | $519 |
| Multiplan | PPO (Includes PHCS as a Payer) | $519 |
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