Emergency visit, high (level 4) at WellSpan Ephrata Community Hospital. CPT 99284.
What WellSpan Ephrata Community Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$2,382cash price (self-pay)
$2,977list price
$154–$2,281range 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 |
| Highmark_Medicare | All_Plans | $415 |
| Aetna_Better_Health_Kids | All_Plans | $418 |
| Aetna_Advantra_Medicare | All_Plans | $424 |
| Aetna_Medicare | All_Plans | $424 |
| Geisinger_Gold_Medicare | All_Plans | $432 |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $432 |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $432 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $434 |
| Amerihealth_Medicare | All_Plans | $434 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $444 |
| PA_Health_&_Wellness_Medicare | All_Plans | $444 |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $524 |
| Highmark | Higmark_Healthy_Kids | $604 |
| Health_Partners_Medicaid | Kidz_Partners | $679 |
| United_Medicaid | Community_Plan_For_Kids | $720 |
| Blue_Cross | Capital_Cares_4_kids | $1,342 |
| Highmark | My_Direct_Blue | $1,434 |
| Highmark | My_Priority_Blue_Flex | $1,434 |
| Highmark | Choice_Blue_PPO | $1,481 |
| Highmark | Performance_Blue | $1,481 |
| Highmark | Blue_Cross_High_Performance_Network | $1,481 |
| Cigna | All_Plans | $1,750 |
| Highmark | All_Other_Plans | $1,784 |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,905 |
Inpatient
$2,382cash price (self-pay)
$2,977list price
$1,900–$2,382range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | All_Plans | $1,900 |
| Independence_Blue_Cross | All_Plans | $1,935 |
| Tower Health | All_Plans | $2,039 |
| PHC | All_Plans | $2,114 |
| UPMC | Employees_And_Dependents | $2,382 |
| UPMC | UPMC_For_Kids | $2,382 |
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