Emergency visit, high (level 4) at Penn Presbyterian Medical Center. CPT 99284.
What Penn Presbyterian Medical Center publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$3,297cash price (self-pay)
$3,297list price
$95.33–$3,873range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| PA Medical Assistance | Medicaid | $95.33 |
| Managed Medicaid Other | Managed Medicaid Other | $95.33 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $110 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $122 |
| United Behavioral Health | United Behavioral Health | $200 |
| UPMC | UPMC Medicaid | $309 |
| Quest Behavioral Health | Quest Behavioral Health | $350 |
| TriCare | TriCare | $439 |
| US Family Health Plan | US Family Health Plan | $504 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $534 |
| Horizon NJ Health | Horizon NJ Health | $580 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $758 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $824 |
| IBC Commercial HPN | IBC Commercial HPN | $999 |
| Independence Blue Cross | Personal Choice-IBC PPO | $1,024 |
| Keystone HMO Proactive | Keystone HMO Proactive | $1,024 |
| Independence Blue Cross | Keystone Health Plan East-IBC HMO | $1,024 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $1,154 |
| Qualcare | Qualcare | $1,253 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $1,289 |
| Wissahickon Hospice | Wissahickon Hospice | $1,319 |
| Pgm - Chop | Pgm - Chop | $1,319 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $1,485 |
| Olympus | Olympus | $1,563 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $1,649 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $1,978 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $2,143 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $2,143 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $2,308 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $2,565 |
Inpatient
$3,297cash price (self-pay)
$3,297list price
$557–$3,297range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $557 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $758 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $824 |
| Devon | Devon Premier | $1,253 |
| Pgm - Chop | Pgm - Chop | $1,319 |
| Coventry | HealthAmerica/Coventry SEPA | $1,319 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $1,484 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $1,616 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $1,649 |
| First Health Global | First Health Global | $1,649 |
| Coventry | Coventry of Delaware | $1,681 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $1,978 |
| Health Net | Health Net | $1,978 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $2,143 |
| Preferred Care | Preferred Care | $2,638 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $2,638 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $2,638 |
| Intergroup | Intergroup | $2,638 |
| Humana Choice Care | Humana Choice Care | $2,638 |
| Health America/CCN | First Health / Coventry National | $2,638 |
| Devon Health Services Inc | Devon Health Services | $2,638 |
| UPMC | UPMC Medicaid | $3,297 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $3,297 |
| United Behavioral Health | United Behavioral Health | $3,297 |
| Quest Behavioral Health | Quest Behavioral Health | $3,297 |
| Managed Medicaid Other | Managed Medicaid Other | $3,297 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $3,297 |
| International PFS | International PFS | $3,297 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $3,297 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $3,297 |
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