Emergency visit, high (level 4) at Ascension Saint Thomas Hickman. CPT 99284.
What Ascension Saint Thomas Hickman publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$107–$4,291range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | 3161_rptn Aetna 20250701 | $107 |
| Aetna | 3162_rhtn Aetna 20250701 | $107 |
| Aetna | 3164_thtn Aetna 20250701 | $114 |
| Amerigroup Mcr Replacement | 2958_rptn Rhtn Thtn Sdtn Medicare Advanta | $326 |
| Amerigroup Mcr Replacement | 2959_sttn Mttn Medicare Advantage Amerigr | $326 |
| BCBS Network E | 3149_blue Cross Blue Shield Network E Regional 202504 | $834 |
| BCBS Missionpoint | 2422_blue Cross Blue Shield Missionpoint Regional | $851 |
| BCBS Network L | 3150_blue Cross Blue Shield Network L Regional 202504 | $906 |
| BCBS Select | 3182_blue Cross Blue Shield Select Regional 20250701 | $955 |
| BCBS Preferred | 3181_blue Cross Blue Shield Preferred Regional 202507 | $1,105 |
| BCBS Aca Exchange | 3147_sttn Blue Cross Blue Shield Network E 2024123 | $1,244 |
| BCBS Aca Exchange | 3146_mttn Blue Cross Blue Shield Network E 2024123 | $1,354 |
| Cigna Localplus | 3187_sttn Cigna Localplus 20250601 | $1,939 |
| Aetna (Rutherford Only) | 3160_mttn Aetna 20250701 | $2,380 |
| Aetna | 3159_sttn Aetna 20250701 | $2,500 |
| UHC Compass/Exchange | 3166_uhc Sttn Exchange 20250715 | $2,854 |
| UHC Compass/Exchange | 3165_mttn UHC Exchange 20250715 | $2,964 |
| UHC Compass/Exchange | 3167_rptn UHC Exchange 20250715 | $3,076 |
| UHC Compass/Exchange | 3169_sdtn UHC Compass 20250715 | $3,076 |
| UHC Compass/Exchange | 3170_thtn UHC Compass 20250715 | $3,076 |
| UHC Compass/Exchange | 3168_rhtn UHC Exchange 20250715 | $3,076 |
| UHC | 3171_mttn UHC 20250715 | $3,788 |
| UHC | 3176_uhc (Sttn) 20250715 | $3,788 |
| UHC | 3172_rptn UHC 20250715 | $4,291 |
| UHC | 3173_rhtn UHC 20250715 | $4,291 |
| UHC | 3174_sdtn UHC 20250715 | $4,291 |
| UHC | 3175_thtn UHC 20250715 | $4,291 |
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