Emergency visit, high (level 4) at Methodist Le Bonheur Germantown Hospital. CPT 99284.
What Methodist Le Bonheur Germantown Hospital publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$504cash price (self-pay)
$2,289list price
$51.00–$9,745range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ar Medicaid Replacement [350010] | Hb Xr Ar Passe Caid/Caresource/Empo | $51.00 |
| Magnolia Medicaid [350020] | Hb Medicaid Ms - Magnolia Healthcare - Tn | $328 |
| Molina Healthcare [350012] | Hb Molina Hc Of Ms - Mscan Mlh-Tn Contrac | $328 |
| UHC Medicaid [350006] | Hb UHC Ms Can Mlh-Ms-Ob Contract | $328 |
| Wellpoint Medicaid [350002] | Hb Amerigroup-Wellpoint Tn Adult Contrac | $329 |
| BCBS Medicare Advantage [450110] | Hb Medicare Advantage / Managed Car | $390 |
| Va Ccn UHC [600003] | Hb Va - Tn Contract | $390 |
| Healthy Mississippi - Medicare Advantage HMO [450114] | Hb Medicare Ad | $390 |
| Medicare [400001] | Hb Medicare-Tn Contract | $390 |
| Shared Health Of Ms - Medicare Advantage [450074] | Hb Medicare Advant | $390 |
| Wellcare Medicare [450023] | Hb Medicare Advantage Wellcare/Wellpoint | $390 |
| United Healthcare Medicare [450021] | Hb Medicare Advantage / Managed | $390 |
| Carecentrix [450200] | Hb Medicare Advantage / Managed Care - Tn Contr | $390 |
| Medicare Priority Health [450072] | Hb Medicare Advantage / Managed CA | $390 |
| Alt BCBS MS Medicare [450116] | HB MEDICARE ADVANTAGE / MANAGED CARE - | $390 |
| Wellpoint Medicare [450090] | Hb Medicare Advantage Wellcare/Wellpoint | $390 |
| Wellcare By Allwell Ar Medicare Advantage [450099] | Hb Medicare Advan | $390 |
| Medipak Advantage - BCBS Ar [450040] | Hb Medicare Advantage / Managed | $390 |
| Tricare [600001] | Hb Tricare - Tn Contract | $396 |
| Devoted Health [450111] | Hb Medicare Advantage Devoted - Tn Contract | $402 |
| Molina Healthcare [350012] | Hb Molina Mschips - Mlh-Tn Contract | $410 |
| UHC Medicaid [350006] | Hb Medicaid Tn - UHC Tenncare (Americhoice) - | $450 |
| CIGNA [100009] | HB CIGNA HMO - Germantown-North-South-Olive Branch-Ca | $578 |
| TRANSPLANT BCBS TENNCARE SELECT [350032] | HB MEDICAID TN - BCBS TennC | $588 |
| UNITED HEALTHCARE [100060] | HB XR TN UHC Exchange | $616 |
| CIGNA [100009] | HB CIGNA IFP - Germantown-North-South-Olive Branch-Ca | $634 |
| CIGNA [100009] | HB CIGNA LocalPlus - Germantown-North-South-Olive Br | $670 |
| CIGNA [100009] | HB Cigna OAP - Germantown-North-South-Olive Branch-C | $740 |
| CIGNA [100009] | HB CIGNA PPO - Germantown-North-South-Olive Branch-Ca | $814 |
| UNITED HEALTHCARE [100060] | HB UHC Heritage Select Contract | $1,194 |
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All common services at Methodist Le Bonheur Germantown Hospital