Emergency visit, moderate (level 3) at Pennsylvania Hospital. CPT 99283.
What Pennsylvania Hospital publishes for this service, straight from its standard-charges file, last updated March 20, 2026.
Outpatient / ER
$1,213cash price (self-pay)
$1,213list price
$56.65–$3,873range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| PA Medical Assistance | Medicaid | $56.65 |
| Managed Medicaid Other | Managed Medicaid Other | $56.65 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $65.15 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $72.51 |
| Quest Behavioral Health | Quest Behavioral Health | $90.00 |
| United Behavioral Health | United Behavioral Health | $200 |
| Horizon NJ Health | Horizon NJ Health | $213 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $279 |
| TriCare | TriCare | $287 |
| UPMC | UPMC Medicaid | $309 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $315 |
| UnitedHealthcare | UnitedHealthcare Compass Exchange | $324 |
| US Family Health Plan | US Family Health Plan | $330 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $425 |
| Qualcare | Qualcare | $461 |
| Wissahickon Hospice | Wissahickon Hospice | $485 |
| Pgm - Chop | Pgm - Chop | $485 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $534 |
| Olympus | Olympus | $590 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $607 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $728 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $788 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $788 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $849 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $948 |
| Preferred Care | Preferred Care | $970 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $970 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $970 |
| Intergroup | Intergroup | $970 |
| Humana Choice Care | Humana Choice Care | $970 |
Inpatient
$1,213cash price (self-pay)
$1,213list price
$205–$1,213range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $205 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $279 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $315 |
| Devon | Devon Premier | $461 |
| Pgm - Chop | Pgm - Chop | $485 |
| Coventry | HealthAmerica/Coventry SEPA | $485 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $546 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $594 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $607 |
| First Health Global | First Health Global | $607 |
| Coventry | Coventry of Delaware | $619 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $728 |
| Health Net | Health Net | $728 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $788 |
| Preferred Care | Preferred Care | $970 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $970 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $970 |
| Intergroup | Intergroup | $970 |
| Humana Choice Care | Humana Choice Care | $970 |
| Health America/CCN | First Health/ Coventry National | $970 |
| Devon Health Services Inc | Devon Health Services | $970 |
| UPMC | UPMC Medicaid | $1,213 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $1,213 |
| United Behavioral Health | United Behavioral Health | $1,213 |
| Quest Behavioral Health | Quest Behavioral Health | $1,213 |
| Managed Medicaid Other | Managed Medicaid Other | $1,213 |
| International PFS | International PFS | $1,213 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $1,213 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $1,213 |
| Health Partners | Health Partners Medicaid | $1,213 |
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