Emergency visit, high (level 4) at Jefferson County Hospital. CPT 99284.
What Jefferson County Hospital publishes for this service, straight from its standard-charges file, last updated March 14, 2026.
Outpatient / ER
$411cash price (self-pay)
$1,172list price
$492–$1,102range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica | PPO | $492 |
| Healthcare Highways | Sync PPO | $516 |
| Humana Military Tricare | All Plans | $633 |
| Friday Health Plan | PPO | $684 |
| Healthcare Highways | Logix PPO | $762 |
| United Healthcare | PPO | $797 |
| Oklahoma Health Network (OHN) | PPO | $938 |
| Aetna | All Plans | $996 |
| Coventry | PPO | $996 |
| Cigna | PPO/POS | $1,055 |
| First Health | PPO | $1,055 |
| OSMA Health | PPO | $1,055 |
| Preferred Community Choice | PPO | $1,078 |
| HealthSmart | PPO | $1,102 |
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