Emergency visit, high (level 4) at WellSpan Evangelical Community Hospital. CPT 99284.
What WellSpan Evangelical Community Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,601cash price (self-pay)
$2,001list price
$112–$3,778range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth_Caritas_Medicaid | All_Plans | $112 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $119 |
| UPMC_Medicaid | All_Plans | $135 |
| UPMC | UPMC_For_Kids | $149 |
| Health_Partners_Medicaid | All_Plans | $154 |
| Geisinger_Medicaid | All_Plans | $160 |
| PA_Health_&_Wellness_Medicaid | All_Plans | $160 |
| Aetna | All_Plans | $410 |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $410 |
| First_Health_Network | All_Plans | $410 |
| Humana_Medicare | All_Plans | $410 |
| United_Medicaid | Community_Plan_For_Kids | $410 |
| Highmark_Medicare | All_Plans | $414 |
| Aetna_Advantra_Medicare | All_Plans | $418 |
| Geisinger_Gold_Medicare | All_Plans | $422 |
| Amerihealth_Medicare | All_Plans | $426 |
| Devoted_Medicare | All_Plans | $430 |
| UPMC_for_Life_Community_HealthChoices | UPMC_for_Life_Complete_Care | $430 |
| United_Medicare | ISNP_DSNP_Plans | $430 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $442 |
| PA_Health_&_Wellness_Medicare | All_Plans | $442 |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $459 |
| Highmark | Higmark_Healthy_Kids | $623 |
| UPMC | All_Plans | $820 |
| Geisinger | All_Plans | $1,337 |
| Performance_Blue | Blue_Cross_High_Performance_Network | $1,488 |
| Highmark | All_Other_Plans | $1,653 |
| United_Healthcare | All_Plans | $1,838 |
| Blue_Cross | Capital_Cares_4_kids | $2,645 |
| Blue_Cross | All_Other_Plans | $3,778 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at WellSpan Evangelical Community Hospital