Emergency visit, high (level 4) at Jefferson Hospital. CPT 99284.
What Jefferson Hospital publishes for this service, straight from its standard-charges file, last updated April 14, 2026.
Outpatient / ER
$64.60cash price (self-pay)
$1,384list price
$80.00–$1,433range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth | Amerihealth Medicaid CHC | $80.00 |
| Amerihealth | Amerihealth Medicaid HC | $80.00 |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $100 |
| University of Pittsburgh Medical Center | University of Pittsburgh Med | $110 |
| Aetna | Aetna Better Health CHIP | $114 |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $132 |
| Community Care Behavorial Health University of Pittsburgh Medical Cent | $138 |
| Community Care Behavorial Health HealthChoices | Community Care Behavo | $138 |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $138 |
| Amerihealth | Amerihealth Caritas HC Medicaid | $138 |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Me | $143 |
| Geisinger | Geisinger CHIP | $153 |
| Geisinger | Geisinger Medicaid HC | $153 |
| United Healthcare | United Healthcare Medicaid | $164 |
| Highmark | Highmark Together Blue | $168 |
| United Healthcare | United Healthcare CHIP | $189 |
| Highmark | Highmark My Direct Blue | $245 |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $265 |
| Highmark | Highmark Social Mission Indemnity | $298 |
| Highmark | Highmark Social Mission Managed Care | $298 |
| Highmark | Highmark My Blue Access | $312 |
| Highmark | Highmark Blue High Performance | $349 |
| Highmark | Highmark Performance Blue | $349 |
| Highmark | Highmark Community Blue Medicare PPO | $377 |
| Highmark | Highmark Complete Blue Medicare | $377 |
| Highmark | Highmark Connect Blue | $379 |
| Highmark | Highmark Freedom Blue | $381 |
| American Health Plans | American Health Plans Medicare | $410 |
| Highmark | Highmark Community Blue | $413 |
| Highmark | Highmark Indemnity | $413 |
Inpatient
$1,966cash price (self-pay)
$2,427list price
$98.57–$229range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Univera | Univera Essential Plan | $98.57 |
| Univera | Univera Healthy New York | $98.57 |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $100 |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $100 |
| Univera | Univera Medicare | $116 |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $126 |
| Community Care Behavorial Health University of Pittsburgh Medical Cent | $138 |
| Community Care Behavorial Health HealthChoices | Community Care Behavo | $138 |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $138 |
| Amerihealth | Amerihealth Caritas HC Medicaid | $138 |
| Geisinger | Geisinger CHIP | $138 |
| Geisinger | Geisinger Medicaid HC | $138 |
| United Healthcare | United Healthcare Medicaid | $138 |
| Univera | Univera Commercial | $139 |
| Highmark | Highmark Together Blue | $144 |
| Highmark | Highmark Blue High Performance | $153 |
| Highmark | Highmark Community Blue | $153 |
| Highmark | Highmark Connect Blue | $153 |
| Highmark | Highmark Indemnity | $153 |
| Highmark | Highmark Managed Care | $153 |
| Highmark | Highmark My Blue Access | $153 |
| Highmark | Highmark My Direct Blue | $153 |
| Highmark | Highmark Performance Blue | $153 |
| Highmark | Highmark Social Mission Indemnity | $153 |
| Highmark | Highmark Social Mission Managed Care | $153 |
| Cigna | Cigna Commercial | $194 |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $217 |
| United Healthcare | United Healthcare Of OH Medicaid | $229 |
| United Healthcare | United Healthcare Commercial | $229 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.