Emergency visit, high (level 4) at lodi hospital. CPT 99284.
What lodi hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$1,910cash price (self-pay)
$2,938list price
$91.53–$2,644range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| OPTUM | Managed Medicaid Transplant | $91.53 |
| Buckeye | Managed Medicaid | $96.35 |
| CARESOURCE | Managed Medicaid | $96.35 |
| ANTHEM | Managed Medicaid | $101 |
| MOLINA | Managed Medicaid | $101 |
| AMERIHEALTH | Managed Medicaid | $106 |
| OPTUM | Medicare Advantage Transplant | $426 |
| OPTUM | All Products VA | $426 |
| Anthem | Medicare Advantage | $426 |
| Oscar | All Products | $831 |
| HUMANA | Medicare Advantage HMO | $881 |
| MMO | Medicare Advantage HMO & PPO | $881 |
| Aetna | Medicare Advantage | $940 |
| Php | All Products | $940 |
| Phphi | All Products | $940 |
| Summacare | MEDICARE ADVANTAGE | $940 |
| Amish Community Aid Plan | ALL PRODUCTS | $1,322 |
| Aultcare | PPO/HMO | $1,413 |
| Ohcp | All Products | $1,428 |
| Omas | All Products | $1,469 |
| Mmo | Traditional | $1,531 |
| Ohio Healthy | TRANSPLANT | $1,587 |
| OPTUM | All Products Transplant | $1,663 |
| AETNA | Acop | $1,669 |
| Summacare | Preferred | $1,692 |
| Anthem | Hpn | $1,779 |
| Cigna | All Products | $1,866 |
| Anthem | Traditional | $1,946 |
| Cc Ehp | All Products | $1,974 |
| AETNA | Asa_Whirlpool_Peia | $2,018 |
Inpatient
$1,910cash price (self-pay)
$2,938list price
$831–$2,644range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Oscar | All Products | $1,060 |
| Amish Community Aid Plan | ALL PRODUCTS | $1,469 |
| Anthem | Hpn | $1,604 |
| Anthem | PPO/HMO | $1,887 |
| Anthem | Traditional | $1,985 |
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