Emergency visit, moderate (level 3) at Ascension Saint Thomas West. CPT 99283.
What Ascension Saint Thomas West publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$735cash price (self-pay)
$2,450list price
$56.40–$2,453range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | 3161_rptn Aetna 20250701 | $56.40 |
| Aetna | 3162_rhtn Aetna 20250701 | $56.40 |
| Aetna | 3164_thtn Aetna 20250701 | $59.88 |
| BCBS Tenncare Select | 2423_bcbs Blue Care Tenncare (West) 20221001 | $87.77 |
| Ascension Complete | 2940_ascension Complete Medicare Advantage Outpat | $265 |
| Centurion Of Tn | 2942_medicare Advantage Centurion Of Tn Outpatient 2 | $265 |
| Clover Medicare Advantage | 2943_medicare Advantage Clover Outpatient | $265 |
| Healthspring Mcr Replacement | 2944_medicare Advantage Healthspring Ou | $265 |
| Humana Mcr Replacement | 2945_medicare Advantage Humana Outpatient 202 | $265 |
| Medicare Other | 2947_medicare Other Outpatient 20250101 | $265 |
| Nhc Advantage | 2948_mttn Rhtn Rptn Sdtn Sttn Medicare Advantage Nhc A | $265 |
| Optum Va | 2935_medicare Advantage Optum Va Outpatient 20250101 | $265 |
| Triwest Va Pccc | 1713_triwest Op (West, Rutherford) 20210101 | $265 |
| UHC Mcr Replacement | 2951_mttn Sttn Rptn Medicare Advantage UHC Outpa | $265 |
| Aetna Medadvantage | 2956_rhtn Rptn Sdtn Thtn Mttn Sttn Medicare Advan | $270 |
| Amerigroup Mcr Replacement | 2959_sttn Mttn Medicare Advantage Amerigr | $300 |
| Amerigroup Mcr Replacement | 2958_rptn Rhtn Thtn Sdtn Medicare Advanta | $326 |
| BCBS Missionpoint | 2410_sttn Blue Cross Blue Shield Mission Point 202 | $652 |
| BCBS Missionpoint | 2422_blue Cross Blue Shield Missionpoint Regional | $679 |
| BCBS Network E | 3149_blue Cross Blue Shield Network E Regional 202504 | $697 |
| BCBS Network L | 3150_blue Cross Blue Shield Network L Regional 202504 | $758 |
| BCBS Select | 3182_blue Cross Blue Shield Select Regional 20250701 | $799 |
| BCBS Aca Exchange | 3147_sttn Blue Cross Blue Shield Network E 2024123 | $856 |
| BCBS Preferred | 3181_blue Cross Blue Shield Preferred Regional 202507 | $926 |
| BCBS Network L | 3152_sttn Blue Cross Blue Shield Network L 20250401 | $930 |
| BCBS Select | 3180_sttn Blue Cross Blue Shield Select 20250701 | $981 |
| BCBS Aca Exchange | 3146_mttn Blue Cross Blue Shield Network E 2024123 | $1,013 |
| BCBS Preferred | 3179_sttn Blue Cross Blue Shield Preferred 20250701 | $1,137 |
| Aetna (Rutherford Only) | 3160_mttn Aetna 20250701 | $1,274 |
| Cigna Localplus | 3187_sttn Cigna Localplus 20250601 | $1,592 |
Inpatient
—cash price (self-pay)
—list price
$239–$371range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Point Comfort Underwriters | 3224_mttn Rhtn Rptn Sdtn Sttn Medicare Ad | $239 |
| Americhoice Medicare | 3207_mttn, Sttn Americhoice Medicare Inpatient | $249 |
| Ascension Complete | 3229_ascension Complete Medicare Advantage Inpati | $265 |
| Centurion Of Tn | 3228_medicare Advantage Centurion Of Tn Inpatient 20 | $265 |
| Clover Medicare Advantage | 3227_medicare Advantage Clover Inpatient 2 | $265 |
| Covid Uninsured Test Fund | 3202_covid Uninsured Test Fund Inpatient 2 | $265 |
| Healthspring Mcr Replacement | 3219_mttn Sttn Rptn Sdtn Rhtn Medicare | $265 |
| Humana Mcr Replacement | 3222_mttn Sttn Medicare Advantage Humana Inpa | $265 |
| Medicare Other | 3204_mttn Sttn Medicare Other Inpatient 20251001 | $265 |
| Nhc Advantage | 3225_mttn Rhtn Rptn Sdtn Sttn Medicare Advantage Nhc A | $265 |
| Optum Va | 3205_medicare Advantage Optum Va Inpatient 20251001 | $265 |
| Triwest Va Pccc | 3235_mttn Sttn Triwest Inpatient 20251001 | $265 |
| UHC Mcr Replacement | 3226_medicare Advantage UHC Inpatient 20251001 | $265 |
| Aetna Medadvantage | 3214_rptn Rhtn Sdtn Thtn Mttn Sttn Medicare Advan | $270 |
| Amerigroup Mcr Replacement | 3210_sttn Mttn Medicare Advantage Amerigr | $273 |
| BCBS Bluecare Plus | 3223_mttn Sttn Medicare Advantage Blue Cross Blue | $276 |
| BCBS Mcr Replacement | 3238_thtn Medicare Advantage Blue Cross Blue Sh | $278 |
| Windsor Medicare | 3220_mttn Sttn Medicare Advantage Wellcare (Windsor | $278 |
| Ambetter Of Tn | 3236_ambetter Of Tn Inpatient 20251001 | $345 |
| Smart Health | 3203_sttn Ascension Smart Health Inpatient 20251001 | $371 |
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