Emergency visit, high (level 4) at Mercy Fitzgerald Hospital. CPT 99284.
What Mercy Fitzgerald Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$5.83–$1,684range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Upmc Medicaid Advantage | Upmc Health Plan Medicaid | $75.00 |
| Allwell Pa Health & Wellness Medicaid Advantage | Pa Health And Wellne | $75.00 |
| Jefferson Health Plans Medicaid | Health Partners Medicaid | $348 |
| Blue Cross - Pa (Independence) Medicare Advantage | Independence Blue | $429 |
| Devoted Health Medicare Advantage | Devoted Health Medicare Advantage | $439 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $454 |
| Health Partners Medicare Advantage | Health Partners Medicare Advantag | $454 |
| Jefferson Health Plans Medicare | Health Partners Medicare Advantage | $454 |
| Upmc Medicare Advantage | Upmc Health Plan Medicare Advantage | $493 |
| United Healthcare | United Healthcare | $514 |
| Coventry Medicare Advantage | Coventry Advantra Medicare Advantage | $514 |
| Health America Advantra | Health America Medicare Advantage | $514 |
| Prime Healthcare | Prime Healthcare | $772 |
| Jefferson Health Plan Commercial | Jefferson Health Plan | $780 |
| Blue Cross - Nc | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Va (Anthem) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Sc | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Tn | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - TX | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Pa (Capital) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Ri | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Or (Regence) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Ak (Premera) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - FL | Independence Blue Cross HMO/PPO | $821 |
| Blue Shield - Id (Regence) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Mn | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Ga (Anthem) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - Wi (Anthem) | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - IL | Independence Blue Cross HMO/PPO | $821 |
| Blue Cross - IL Alternate | Independence Blue Cross HMO/PPO | $821 |
Inpatient
$250cash price (self-pay)
$250list price
$76.68–$250range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tenncare | Medicaid | $95.33 |
| Molina Centennial Care | Medicaid | $95.33 |
| Prestige Health Choice | Medicaid | $95.33 |
| Security Health Medicaid | Medicaid | $95.33 |
| Unity Medicaid | Medicaid | $95.33 |
| Blue Cross - Tn Medicaid Advantage | Medicaid | $95.33 |
| Caresource Medicaid | Medicaid | $95.33 |
| Amerihealth Caritas Medicaid | Medicaid | $95.33 |
| Managed Health Services - Indiana | Medicaid | $95.33 |
| Wi Womens Wellness | Medicaid | $95.33 |
| Mercycare Medicaid | Medicaid | $95.33 |
| Nebraska Total Care | Medicaid | $95.33 |
| Care Wisconsin Medicaid | Medicaid | $95.33 |
| Rx Meridian Rx | Medicaid | $95.33 |
| Delaware First Health | Medicaid | $95.33 |
| Huron Valley Pace Medicaid | Medicaid | $95.33 |
| Us Family Health Plan | Tricare | $116 |
| Molina Medicare Advantage | Medicare | $120 |
| Rx Allwin | Medicare | $120 |
| Optum Medicare Transplant | Medicare | $120 |
| Humana Medicare Transplant | Medicare | $120 |
| Eddy Senior Care-Pace | Medicare | $120 |
| Sunnyview-Pace Finance Dept | Medicare | $120 |
| Gateway Health Plan | Medicare | $120 |
| Aetna Medicare Transplant | Medicare | $120 |
| Gold Kidney Medicare | Medicare | $120 |
| Humana Central Valley Medpro | Medicare | $120 |
| Wc Federal Black Lung | Workers Comp | $139 |
| Wc Ford Motor | Workers Comp | $139 |
| Wc Asu Risk Mgt | Workers Comp | $139 |
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