Emergency visit, high (level 4) at UPMC Northwest. CPT 99284.
What UPMC Northwest publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$570cash price (self-pay)
$950list price
$105–$808range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Health Plan | Managed Medicaid | $105 |
| United Healthcare Community Plan for Families | Unison Kids | $110 |
| Aetna | Medicaid | $114 |
| Highmark Wholecare (prev Gateway) | Medicaid | $141 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $149 |
| PA Health & Wellness | PA Medicaid HMO | $162 |
| UPMC Work Partners | Workers Comp | $163 |
| UPMC Health Plan | Commercial | $302 |
| UPMC Health Plan | Managed Medicare | $368 |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Ca | $368 |
| Aetna | EBR ASO | $380 |
| Cigna | Commercial | $380 |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue | $406 |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $416 |
| Aetna | Medicare | $418 |
| United Healthcare | Unison Advantage Non Special Needs | $426 |
| Aetna of PA | Medicare | $426 |
| Highmark Wholecare (prev Gateway) | Medicare | $438 |
| AmeriHealth Caritas | Medicare | $438 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $438 |
| United Healthcare | Unison Advantage Special Needs | $447 |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $454 |
| Aetna | EBR FI | $570 |
| Aetna | Neighborhood Network | $570 |
| Aetna | Home Depot Employer Group | $586 |
| Aetna | NBR ASO/FI | $599 |
| Cigna | New Business ASO | $599 |
| InterGroup | PPO | $651 |
| Coventry/First Health | Commercial | $665 |
| Health Coalition Partners | PPO | $684 |
Inpatient
$570cash price (self-pay)
$950list price
$380–$3,704range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | EBR ASO | $380 |
| Cigna | Commercial | $380 |
| Aetna | EBR FI | $551 |
| Aetna | Neighborhood Network | $589 |
| Aetna | Home Depot Employer Group | $605 |
| Aetna | NBR ASO/FI | $618 |
| Cigna | New Business ASO | $618 |
| Coventry/First Health | Commercial | $665 |
| Private Health Care Systems | PPO | $760 |
| Humana | Commercial | $808 |
| InterGroup | PPO | $2,161 |
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