Emergency visit, high (level 4) at Adena Fayette Medical Center. CPT 99284.
What Adena Fayette Medical Center publishes for this service, straight from its standard-charges file, last updated August 19, 2026.
Outpatient / ER
$931cash price (self-pay)
$1,861list price
$484–$2,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicare Advantage | $484 |
| Medical Mutual of Ohio | Medicare Advantage | $763 |
| Molina | Medicare Advantage/Dual | $763 |
| Medigold | Medicare Advantage | $763 |
| Humana/Choice Care | Medicare Advantage | $763 |
| Buckeye Community Health Plan | Medicare Advantage | $763 |
| Aetna | Medicare Advantage | $763 |
| Care Source | Medicare Advantage | $778 |
| Care Source Just4Me | Commercial | $853 |
| Molina Marketplace | Commercial | $874 |
| Anthem Pathway | HMO/PPO | $897 |
| Anthem | Blue Preferred/Blue Access | $1,132 |
| United Healthcare | Commercial | $1,160 |
| United Medical Resources OHCP | Commercial | $1,171 |
| United Healthcare River Valley | Commercial | $1,171 |
| GEHA UHC Shared Services | Commercial | $1,171 |
| Anthem | Traditional | $1,219 |
| Great West Health Care/Cigna | Commercial | $1,283 |
| Ohio PPO Connect | Commercial | $1,303 |
| The Health Plan | Commercial | $1,303 |
| Medical Mutual of Ohio | Commercial | $1,405 |
| Medical Mutual of Ohio SuperMed | HMO/PPO/POS/Preferred | $1,405 |
| Medical Mutual of Ohio | Traditional Commercial | $1,405 |
| First Health | Commercial | $1,459 |
| Aetna (Cofinity/Meritain) | Commercial | $1,474 |
| Ohio Health Choice | Commercial | $1,482 |
| Sidecar Health | Commercial | $2,103 |
Inpatient
$931cash price (self-pay)
$1,861list price
$817–$1,482range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Pathway | HMO/PPO | $817 |
| Anthem | Blue Preferred/Blue Access | $1,121 |
| United Healthcare | Commercial | $1,160 |
| United Medical Resources OHCP | Commercial | $1,171 |
| United Healthcare River Valley | Commercial | $1,171 |
| GEHA UHC Shared Services | Commercial | $1,171 |
| Anthem | Traditional | $1,208 |
| Great West Health Care/Cigna | Commercial | $1,283 |
| The Health Plan | Commercial | $1,303 |
| Ohio PPO Connect | Commercial | $1,303 |
| Medical Mutual of Ohio SuperMed | HMO/PPO/POS/Preferred | $1,405 |
| Medical Mutual of Ohio | Traditional Commercial | $1,405 |
| Medical Mutual of Ohio | Commercial | $1,405 |
| First Health | Commercial | $1,459 |
| Aetna (Cofinity/Meritain) | Commercial | $1,474 |
| Ohio Health Choice | Commercial | $1,482 |
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