Emergency visit, high (level 4) at Peninsula Behavioral Health. CPT 99284.
What Peninsula Behavioral Health publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$132–$1,035range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Commercial | $132 |
| Optum | VA CCN | $379 |
| Tricare | Humana Military | $379 |
| Humana | DSNP | $390 |
| Humana | Medicare Advantage | $390 |
| American Health Plan | ISNP | $398 |
| Blue Cross of TN | BlueEssential DSNP | $398 |
| Blue Cross of TN | BlueEssential HMO | $398 |
| Blue Cross of TN | Med Adv Diamond | $398 |
| Blue Cross of TN | Med Adv PPO | $398 |
| Blue Cross of TN | Med Adv Ruby | $398 |
| Blue Cross of TN | Med Adv Sapphire | $398 |
| Cigna | Medicare HMO-POS | $398 |
| Cigna | Medicare PPO | $398 |
| Devoted Health | HMO | $398 |
| Devoted Health | PPO | $398 |
| NHC Advantage | ISNP | $398 |
| Wellcare | Medicare Advantage | $398 |
| Ambetter | Exchange | $1,035 |
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