Emergency visit, high (level 4) at Prisma Health Blount Memorial Hospital. CPT 99284.
What Prisma Health Blount Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$601cash price (self-pay)
$1,939list price
$50.00–$2,400range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid Tn-Tenncare UHC Community Plan [3231] | Phtn Hb UHC Community | $50.00 |
| Medicaid Tn-Tenncare Bluecare [3230] | Phtn Hb Bluecare Of Tenn Medica | $153 |
| Medicaid Tn-Tenncare Select [3232] | Phtn Hb Tenncare Medicaid Select | $175 |
| MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $299 |
| MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $299 |
| MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $299 |
| MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $299 |
| MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $299 |
| MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $299 |
| Carelon Behavioral Health [3180] | Phu Hb Carelon Behavioral Health Up | $350 |
| Medicaid Tn-Tenncare Wellpoint [3233] | Phtn Hb Wellpoint Medicaid - B | $375 |
| Humana Medicare Supplement [3091] | Phtn Hb Humana Medicare - Blount | $392 |
| Medicare BCBS [210] | Phtn Hb 100% Of Medicare - Blount | $392 |
| Medicare Humana [205] | Phtn Hb Humana Medicare - Blount | $392 |
| Medicare Wellcare [255] | Phtn Hb 100% Of Medicare - Blount | $392 |
| Medicare [200] | Phtn Hb Medicare - Blount | $396 |
| Medicare United Healthcare [230] | Phtn Hb UHC Medicare - Blount | $406 |
| Medicare BCBS [210] | Phtn Hb Bluecare Plus Medicare - Blount | $408 |
| Medicare Healthspring Fka Cigna [250] | Phtn Hb Healthspring Medicare | $408 |
| Medicare Wellpoint [256] | Phtn Hb Wellpoint Medicare - Blount | $408 |
| Cigna [2800] | Phtn Hb Cigna - Blount | $532 |
| Ambetter Exchange-All States Contracted [4121] | Phtn Hb Ambetter Atc | $614 |
| Consociate Health Contracted [4835] | Phtn Hb Consociate Care Medicare | $872 |
| Fairos/Occunet Contracted [4837] | Phtn Hb Occunet Medicare - Blount | $911 |
| Cigna [2800] | Phtn Hb Blount County Govt - Blount | $1,066 |
| BOB JONES UNIV-PAI [821] | GHS HB MyHFN BOB JONES PAI | $1,163 |
| Medcost [2940] | Ph Hb Medcost Benefit Services | $1,435 |
| Atlantic Packaging Contracted [4833] | Ph Hb Atlantic Packaging | $1,454 |
| Aps Healthcare System [2981] | Ghs Hb American Psych Services (Aps) | $1,551 |
| Medcost [2940] | Ph Hb Medcost | $1,609 |
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All common services at Prisma Health Blount Memorial Hospital