Emergency visit, high (level 4) at Adena Pike Medical Center. CPT 99284.
What Adena Pike 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
$447–$1,768range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina | Medicare Advantage | $447 |
| Humana | Medicare Advantage | $447 |
| Medigold | Medicare Advantage | $447 |
| Medical Mutual of Ohio | Medicare Advantage | $447 |
| Buckeye Community Health Plan | Medicare Advantage | $447 |
| Aetna | Medicare Advantage | $447 |
| Care Source | Medicare Advantage | $456 |
| Anthem | Medicare Advantage | $577 |
| Gateway Health | Commercial | $614 |
| Molina Marketplace | Commercial | $853 |
| Care Source Just4Me | Commercial | $853 |
| United Healthcare | All Plans | $970 |
| Anthem Ohio Exchange | PPO | $1,227 |
| Anthem Ohio Exchange | HMO | $1,227 |
| Sidecar Health | Commercial | $1,229 |
| The Health Plan | Commercial | $1,303 |
| Ohio PPO Connect | Commercial | $1,303 |
| Medical Mutual of Ohio SuperMed | Commercial | $1,336 |
| Medical Mutual of Ohio | Managed Care | $1,336 |
| Great West Health Care/Cigna | Commercial | $1,348 |
| Anthem | Traditional | $1,379 |
| First Health | Commercial | $1,459 |
| Ohio Health Choice | Commercial | $1,482 |
| Aetna (Cofinity/Meritain) | Commercial | $1,515 |
| Anthem Pathway | HMO/PPO | $1,606 |
| Integrated Health Plan | Commercial | $1,750 |
| Three Rivers Network | Commercial | $1,768 |
| HealthSmart | Emerald Commercial Products | $1,768 |
| Multiplan/Private Healthcare Systems | Commercial | $1,768 |
Inpatient
$931cash price (self-pay)
$1,861list price
$1,180–$1,768range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Ohio Exchange | HMO | $1,180 |
| Anthem Ohio Exchange | PPO | $1,180 |
| Ohio PPO Connect | Commercial | $1,303 |
| The Health Plan | Commercial | $1,303 |
| Medical Mutual of Ohio | Managed Care | $1,336 |
| Medical Mutual of Ohio SuperMed | Commercial | $1,336 |
| Great West Health Care/Cigna | Commercial | $1,348 |
| Anthem | Traditional | $1,379 |
| First Health | Commercial | $1,459 |
| Ohio Health Choice | Commercial | $1,482 |
| Aetna (Cofinity/Meritain) | Commercial | $1,515 |
| Anthem Pathway | HMO/PPO | $1,564 |
| Integrated Health Plan | Commercial | $1,750 |
| Three Rivers Network | Commercial | $1,768 |
| Multiplan/Private Healthcare Systems | Commercial | $1,768 |
| HealthSmart | Emerald Commercial Products | $1,768 |
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