Emergency visit, high (level 4) at Prague Regional Memorial Hospital. CPT 99284.
What Prague Regional Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 30, 2026.
Outpatient / ER
$114cash price (self-pay)
$431list price
$39.00–$900range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS HMO/Adv PPO | BCBS HMO/Adv PPO | $39.00 |
| BCBS Blue Pref PPO | BCBS Blue Pref PPO | $47.00 |
| BCBS Blue Choice PPO | BCBS Blue Choice PPO | $52.00 |
| BCBS Trad - All Other Plans | BCBS Trad - All Other Plans | $55.00 |
| BCBS Native Blue | BCBS Native Blue | $117 |
| UHC Comm - All Other Plans | UHC Comm - All Other Plans | $301 |
| Hch Comm - All Plans | Hch Comm - All Plans | $311 |
| BCBS Mcare Select | BCBS Mcare Select | $312 |
| Humana Mcr Adv | Humana Mcr Adv | $312 |
| UHC Mcr Adv | UHC Mcr Adv | $312 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $312 |
| BCBS Mcr Adv | BCBS Mcr Adv | $312 |
| Va Ccn - All Plans | Va Ccn - All Plans | $312 |
| Aetna Mcr Adv | Aetna Mcr Adv | $321 |
| Cigna - All Plans | Cigna - All Plans | $380 |
| Humana Comm - All Other Plans | Humana Comm - All Other Plans | $382 |
| Aetna Better Hlth | Aetna Better Hlth | $471 |
| Humana Mcaid | Humana Mcaid | $471 |
| Sonnerselect Mcaid - All Plans | Sonnerselect Mcaid - All Plans | $471 |
| Ambetter Exchange - All Plans | Ambetter Exchange - All Plans | $474 |
| Aetna Comm - All Other Plans | Aetna Comm - All Other Plans | $504 |
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