Emergency visit, high (level 4) at Mercy Hospital Tishomingo. CPT 99284.
What Mercy Hospital Tishomingo publishes for this service, straight from its standard-charges file, last updated June 11, 2026.
Outpatient / ER
$290cash price (self-pay)
$525list price
$112–$639range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Provider Partners Health Plans Contracted [320450] | Hb Tish Managed M | $112 |
| Halo Hcr Inc Hospice Contracted [320432] | Hb Tish Managed Medicare 10 | $112 |
| Elara Caring Aspire Hospice Contracted [320433] | Hb Tish Managed Medi | $112 |
| Kindful Hospice Contracted [320434] | Hb Tish Managed Medicare 100% W/ | $112 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Tis | $112 |
| Aetna Medicare Advantage Contracted [320010] | Hb Tish Managed Medicar | $112 |
| BCBS Medicare Advantage Contracted [320047] | Hb Tish Managed Medicare | $112 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Tish Managed Medi | $112 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Tish Managed Medicare | $112 |
| Elara Caring Aspire Hospice [20433] | Hb Tish Managed Medicare 100% W/ | $112 |
| Kindful Hospice [20434] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Medical Associates Health [20444] | Hb Tish Managed Medicare 100% W/Se | $112 |
| Medicare [20244] | Hb Tish Medicare | $112 |
| Mental Health Network Medicare [20250] | Hb Tish Managed Medicare 100% | $112 |
| Independent Health [20197] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Halo Hcr Inc Hospice [20432] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Windsor Medicare [20424] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Mercy Hospice Okc [20252] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Tricare [20380] | Hb Tish Tricare | $112 |
| BCBS Medicare Advantage [20047] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Cross Timbers Hospice [20098] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Health First Health Plans Medicare [20170] | Hb Tish Managed Medicare | $112 |
| Horizons Medicare [20190] | Hb Tish Managed Medicare 100% W/Seq | $112 |
| Essence Healthcare Medicare Contracted [320122] | Hb Tish Managed Medi | $112 |
| Medica Medicare Advantage Contracted [320477] | Hb Tish Medica Medicar | $115 |
| Medica Medicare Advantage [20477] | Hb Tish Medica Medicare New 031523 | $115 |
| Devoted Health Medicare Contracted [320500] | Hb Tish Devoted Health M | $115 |
| Globalhealth Contracted [320145] | Hb Tish Globalhealth Mcr 102% W/Seq | $115 |
| Healthspring Medicare Advantage Contracted [320526] | Hb Tish Cigna Mc | $116 |
| Cigna Medicare Advantage Contracted [320072] | Hb Tish Cigna Mcr W/Seq | $116 |
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