Emergency visit, moderate (level 3) at Samaritan Pacific Communities Hospital. CPT 99283.
What Samaritan Pacific Communities Hospital publishes for this service, straight from its standard-charges file, last updated January 31, 2026.
Outpatient / ER
$216cash price (self-pay)
$270list price
$59.82–$1,170range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Health | Medicare Advantage - Midlevel - Nonfac | $66.72 |
| Devoted Health | Medicare Advantage - Midlevel - Fac | $66.72 |
| Healthnet | Medicare Advantage - Midlevel - Nonfac | $66.72 |
| DEVOTED HEALTH | Medicare Advantage-NONFAC | $76.18 |
| DEVOTED HEALTH | Medicare Advantage-FAC | $76.18 |
| Healthnet | Medicare Advantage - Nonfac | $78.49 |
| Cigna | Nonfacility | $100 |
| Cigna | Facility | $100 |
| Aetna | Fac - Midlevel Lcsw/Lpc/Rdn | $119 |
| Aetna | Nonfac - Midlevel Lcsw/Lpc/Rdn | $119 |
| Healthnet | Facility | $131 |
| Aetna | Nonfac - Optometrists - Pyschologists- Pt-St-Ot | $134 |
| Aetna | Nonfac - Midlevel Np-Pa-Cnm | $134 |
| Aetna | Fac - Optometrists - Pyschologists- Pt-St-Ot | $134 |
| Aetna | Fac - Midlevel Np-Pa-Cnm | $134 |
| Aetna | Nonfac - Md-Do | $158 |
| Aetna | Fac - Md-Do | $158 |
| Aetna | Fac - Psychiatric Np | $158 |
| Aetna | Nonfac - Psychiatric Np | $158 |
| First Choice | Facility | $161 |
| First Choice | Nonfacility | $161 |
| Providence | Medicare Adv. - Physician | $162 |
| Providence | Medicare Adv. | $396 |
| Humana | Medicare Adv. | $400 |
| Samaritan | Medicare Adv. | $400 |
| Regence | Medicare Adv. | $436 |
| Pacificsource | Medicare Adv. | $444 |
| Devoted Health | Devoted Health Mcr Advantage | $455 |
| Samaritan | EPO | $840 |
| Samaritan | Samaritan Choice | $960 |
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All common services at Samaritan Pacific Communities Hospital