Emergency visit, highest (level 5) at Ascension Seton Edgar B. Davis (Ascension Seton). CPT 99285.
What Ascension Seton Edgar B. Davis (Ascension Seton) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,380cash price (self-pay)
$3,833list price
$200–$5,800range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior Star | 3509_chirp Superior Star (Chi,Dcn) Inpatient 20240901 | $200 |
| Superior Star | 3511_chirp Superior Star (Ebd) Inpatient 20240901 | $200 |
| Superior Star Plus | 4375_chirp Superior Star Plus (Chi,Dcn) Inpatient | $200 |
| Superior Star Plus | 4377_chirp Superior Star Plus (Ebd) Inpatient 202 | $200 |
| BCBS Star | 4221_chirp Blue Cross Star (Ebd) Outpatient 20241201 | $383 |
| Superior Ambetter | 3879_superior Ambetter (Chi,Dcn) Inpatient 2024090 | $435 |
| Superior Ambetter | 3880_superior Ambetter (Chi,Dcn) Outpatient 202409 | $435 |
| Tricare | 1229_tricare Cah Outpatient 20170101 | $470 |
| BCBS Chip/Chip Perinate | 4170_blue Cross Chip (Ebd) Outpatient 202412 | $498 |
| BCBS Chip/Chip Perinate | 4170_blue Cross Chip/Star Kids (Ebd) Outpati | $498 |
| BCBS Chip/Chip Perinate | 3594_blue Cross Chip/Star Kids (Chi,Dcn) Inp | $554 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip (Chi,Dcn) Outpatient 20 | $554 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip/Star Kids (Chi,Dcn) Out | $554 |
| BCBS Star | 3693_chirp Blue Cross Star (Chi,Dcn) Inpatient 20240901 | $554 |
| BCBS Chip/Chip Perinate | 3596_blue Cross Chip/Star Kids (Ebd) Inpatie | $613 |
| BCBS Star | 3695_chirp Blue Cross Star (Ebd) Inpatient 20240901 | $613 |
| Whole Foods | 4512_whole Foods 20251001 | $1,368 |
| Seton Performance Plus | 785_seton Performance EPO PPO (Aus,Nw,Sw,Hay) | $1,572 |
| Seton Performance Plus | 788_seton Performance EPO PPO (Wil,Del,Brk,Ba | $1,572 |
| Oscar Health Exchange | 4511_oscar Health Plan 20251001 | $1,662 |
| Humana HMO | 2668_humana HMO 20230701 | $1,668 |
| BCBS Hpn | 4440_blue Cross Blue Shield Hpn 20250501 | $1,715 |
| BCBS Hpn | 4497_blue Cross Blue Shield Hpn (Dell, Williamson,Hays) 202 | $1,715 |
| Cigna HMO | 4475_cigna HMO (Aus,Nw,Sw,Hay) 20250701 | $1,725 |
| BCBS HMO Essentials | 4095_blue Cross Blue Shield HMO Essentials 20250 | $1,892 |
| Humana Mcr Replacement | 4111_medicare Advantage Humana Outpatient (Br | $2,060 |
| Humana Mcr Replacement | 4661_medicare Advantage Humana Inpatient (Aus | $2,060 |
| Humana Mcr Replacement | 4662_medicare Advantage Humana Inpatient (Brk | $2,060 |
| Humana Mcr Replacement | 4921_medicare Advantage Humana Outpatient (Au | $2,060 |
| BCBS PPO | 4094_blue Cross Blue Shield PPO 20250101 | $2,094 |
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All common services at Ascension Seton Edgar B. Davis (Ascension Seton)