Emergency visit, high (level 4) at WellSpan Chambersburg Hospital. CPT 99284.
What WellSpan Chambersburg Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,797cash price (self-pay)
$2,246list price
$154–$3,535range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Geisinger_Medicaid | All_Plans | $154 |
| Health_Partners_Medicaid | All_Other_Plans | $154 |
| PA_Health_&_Wellness_Medicaid | All_Plans | $154 |
| UPMC_Medicaid | All_Plans | $154 |
| Amerihealth_Caritas_Medicaid | All_Plans | $200 |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $255 |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $440 |
| United_Medicaid | Community_Plan_For_Kids | $440 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $445 |
| Highmark_Medicare | All_Plans | $445 |
| Aetna_Advantra_Medicare | All_Plans | $453 |
| Aetna_Medicare | All_Plans | $453 |
| Devoted_Medicare | All_Plans | $462 |
| Amerihealth_Medicare | All_Plans | $464 |
| Geisinger_Gold_Medicare | All_Plans | $471 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $475 |
| PA_Health_&_Wellness_Medicare | All_Plans | $475 |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $572 |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $572 |
| Highmark | Higmark_Healthy_Kids | $629 |
| Health_Partners_Medicaid | Kidz_Partners | $726 |
| UPMC | UPMC_For_Kids | $1,348 |
| Aetna_Better_Health_Kids | All_Plans | $1,497 |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,617 |
| Aetna | All_Plans | $1,626 |
| Highmark | Choice_Blue_PPO | $1,649 |
| Performance_Blue | Blue_Cross_High_Performance_Network | $1,649 |
| Highmark | Blue_Cross_High_Performance_Network | $1,649 |
| Highmark | All_Other_Plans | $1,649 |
| Geisinger | All_Plans | $1,662 |
Inpatient
$1,797cash price (self-pay)
$2,246list price
$1,507–$2,134range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | All_Plans | $1,507 |
| Geisinger | All_Plans | $1,662 |
| Cigna | All_Plans | $1,673 |
| Aetna | PPO_Plan | $1,709 |
| Cigna | PPO_Plan | $1,757 |
| UPMC | UPMC_For_Kids | $1,909 |
| First_Health_Network | All_Plans | $2,134 |
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