Emergency visit, high (level 4) at Legacy Good Samaritan Medical Center. CPT 99284.
What Legacy Good Samaritan Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$219cash price (self-pay)
$646list price
$464–$1,794range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $464 |
| Atrio | Medicare Managed Care Plan | $478 |
| Aetna | Medicare Managed Care Plan | $487 |
| HealthNet | Medicare Managed Care Plan | $492 |
| CareOregon | Medicare Managed Care Plan | $501 |
| Ageright | Medicare Managed Care Plan | $510 |
| Moda | Medicare Managed Care Plan | $519 |
| Kaiser | PEBB Other Commercial Plan | $928 |
| BCBS | Regence - Legacy LHP All Commercial Plans | $992 |
| BCBS | Regence - Blue HPN All Commercial Plans | $1,388 |
| BCBS | Regence All Commercial Plans | $1,453 |
| Moda | All Commercial Plans | $1,794 |
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