Emergency visit, moderate (level 3) at Pomerene Hospital. CPT 99283.
What Pomerene Hospital publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$194cash price (self-pay)
$429list price
$37.68–$573range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Buckeye Ohio Medicaid MCE | Default | $37.68 |
| CareSource OH MCE | Default | $37.68 |
| Medicaid Ohio | Default | $37.68 |
| Paramount Care MCD Rep | Default | $37.68 |
| AmeriHealth Caritas Ohio - Nontransportation MCE | Default | $39.56 |
| Molina Healthcare of Ohio MCD Rep | Default | $39.56 |
| Medicare B OH J15 | Default | $67.34 |
| AultCare MA | Default | $160 |
| Blue Cross Blue Shield of OH Anthem MCR Adv | Default | $160 |
| Humana Advantage Care Plans Med Advantage | Default | $160 |
| Medical Mutual of Ohio MCR Adv | Default | $160 |
| Molina Healthcare of Ohio MCR Adv | Default | $160 |
| SummaCare Health Plan MA | Default | $160 |
| Aetna Medicare Advantage | Default | $163 |
| UHC Group Medicare Advantage | Default | $163 |
| Optum Medical Network (Lifeprint) | Default | $163 |
| UHC Community Plan Ohio | Default | $242 |
| Medicare A OH J15 | Default | $253 |
| VALOR HEALTH PLAN | Default | $253 |
| Medical Mutual of Ohio | Default | $299 |
| Cigna | Default | $353 |
| Blue Cross Blue Shield of OH Anthem | Default | $358 |
| AultCare | Default | $373 |
| Aetna | Default | $378 |
| United Healthcare | Default | $378 |
| SummaCare Health Plan | Default | $399 |
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