Emergency visit, high (level 4) at St. Charles Prineville. CPT 99284.
What St. Charles Prineville publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$386cash price (self-pay)
$2,086list price
$113–$2,086range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| PACIFICSOURCE COMMUNITY SOLUTIONS [525] | PacificSource Central Oregon | $412 |
| Law Enforcement [701] | Schs Sph Hb Law Enforcement | $584 |
| KAISER PERMANENTE MED ADV [136] | Medicare | $584 |
| MEDICARE VACCINE [999100100] | Medicare | $584 |
| HEALTH NET MED ADV [135] | Medicare | $584 |
| INDIAN HEALTH [704] | Medicare | $584 |
| MEDICARE ADVANTAGE GENERIC [199] | Medicare | $584 |
| CHAMP VA [700] | Veteran Affairs | $584 |
| HUMANA MC AB REBILL [176] | Medicare | $584 |
| VETERANS [706] | Veteran Affairs | $584 |
| OTJ DEPT OF LABOR FEDERAL EMP [652] | US Dept of Labor | $621 |
| PROVIDENCE MEDICARE ADV [137] | Providence Medicare | $678 |
| WILLAMETTE VALLEY COMMUNITY HEALTH [536] | Oregon Medicaid CCO | $730 |
| HEALTH SHARE KAISER [543] | Oregon Medicaid CCO | $730 |
| ALLCARE HEALTH PLAN [538] | Oregon Medicaid CCO | $730 |
| TRILLIUM MEDICAID [535] | Oregon Medicaid CCO | $730 |
| UMPQUA HEALTH [533] | Oregon Medicaid CCO | $730 |
| PRIMARY HEALTH OF JOSPEHINE COUNTY LLC [547] | Oregon Medicaid CCO | $730 |
| PACIFICSOURCE [345] | PacificSource Voyager | $835 |
| KAISER PERMANENTE [334] | OEBB PEBB Non-Contracted | $919 |
| MODA [310] | Moda OEBB PEBB | $993 |
| US BENEFITS [326] | Cigna | $1,314 |
| MODA [310] | Moda Affinity | $1,794 |
| MODA [310] | Moda Synergy | $1,794 |
| MERITAIN HEALTH [300] | Aetna | $1,815 |
| MANHATTAN LIFE INSURANCE COMPANY [379] | First Health | $2,045 |
| FIRST HEALTH [339] | First Health | $2,045 |
| PLANNED ADMINISTRATORS INC [375] | First Health | $2,045 |
| OTJ CITY COUNTY INS SERVICES [662] | Oregon Workers Compensation | $2,086 |
| OTJ TRAVELERS INSURANCE [672] | Oregon Workers Compensation | $2,086 |
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