Emergency visit, highest (level 5) at Samaritan Lebanon Community Hospital. CPT 99285.
What Samaritan Lebanon Community Hospital publishes for this service, straight from its standard-charges file, last updated January 31, 2026.
Outpatient / ER
$530cash price (self-pay)
$663list price
$148–$2,619range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Health | Medicare Advantage - Midlevel - Nonfac | $165 |
| Devoted Health | Medicare Advantage - Midlevel - Fac | $165 |
| Healthnet | Medicare Advantage - Midlevel - Nonfac | $165 |
| DEVOTED HEALTH | Medicare Advantage-NONFAC | $188 |
| DEVOTED HEALTH | Medicare Advantage-FAC | $188 |
| Healthnet | Medicare Advantage - Nonfac | $194 |
| Cigna | Nonfacility | $248 |
| Cigna | Facility | $248 |
| Aetna | Fac - Midlevel Lcsw/Lpc/Rdn | $291 |
| Aetna | Nonfac - Midlevel Lcsw/Lpc/Rdn | $291 |
| Aetna | Nonfac - Optometrists - Pyschologists- Pt-St-Ot | $330 |
| Aetna | Nonfac - Midlevel Np-Pa-Cnm | $330 |
| Aetna | Fac - Optometrists - Pyschologists- Pt-St-Ot | $330 |
| Aetna | Fac - Midlevel Np-Pa-Cnm | $330 |
| Healthnet | Facility | $366 |
| Healthnet | Nonfacility | $366 |
| Aetna | Nonfac - Md-Do | $388 |
| Aetna | Fac - Md-Do | $388 |
| Aetna | Fac - Psychiatric Np | $388 |
| Aetna | Nonfac - Psychiatric Np | $388 |
| First Choice | Facility | $393 |
| First Choice | Nonfacility | $393 |
| Providence | Medicare Adv. - Physician | $398 |
| Providence | Medicare Adv. | $783 |
| Providence | MA-Behavioral Health | $783 |
| Samaritan | Medicare Adv. | $791 |
| Healthnet | Medicare Adv. | $861 |
| Regence | Medicare Adv. | $861 |
| Pacificsource | Medicare Adv. | $877 |
| Devoted Health | Devoted Health Mcr Advantage | $900 |
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