Emergency visit, highest (level 5) at Ascension Seton Smithville (Ascension Seton). CPT 99285.
What Ascension Seton Smithville (Ascension Seton) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,522cash price (self-pay)
$5,082list price
$200–$5,800range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior Star | 3509_chirp Superior Star (Chi,Dcn) Inpatient 20240901 | $200 |
| Superior Star | 3515_chirp Superior Star (Smv) Inpatient 20240901 | $200 |
| Superior Star | 4247_chirp Superior Star (Smv) Outpatient 20241201 | $200 |
| Superior Star Plus | 4375_chirp Superior Star Plus (Chi,Dcn) Inpatient | $200 |
| Superior Star Plus | 4381_chirp Superior Star Plus (Smv) Inpatient 202 | $200 |
| Superior Star Plus | 4401_chirp Superior Star Plus (Smv) Outpatient 20 | $200 |
| 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 | 4174_blue Cross Chip (Smv) Outpatient 202412 | $482 |
| BCBS Chip/Chip Perinate | 4174_blue Cross Chip/Star Kids (Smv) Outpati | $482 |
| BCBS Chip/Chip Perinate | 3600_blue Cross Chip/Star Kids (Smv) Inpatie | $602 |
| BCBS Chip/Chip Perinate | 3594_blue Cross Chip/Star Kids (Chi,Dcn) Inp | $806 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip (Chi,Dcn) Outpatient 20 | $806 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip/Star Kids (Chi,Dcn) Out | $806 |
| Whole Foods | 4512_whole Foods 20251001 | $1,368 |
| Oscar Health Exchange | 4511_oscar Health Plan 20251001 | $1,662 |
| Humana HMO | 2668_humana HMO 20230701 | $1,668 |
| 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 |
| Seton Performance Plus | 785_seton Performance EPO PPO (Aus,Nw,Sw,Hay) | $2,286 |
| Seton Performance Plus | 788_seton Performance EPO PPO (Wil,Del,Brk,Ba | $2,286 |
| Cigna HMO | 4475_cigna HMO (Aus,Nw,Sw,Hay) 20250701 | $2,509 |
| Aetna Choice | 236_aetna Elect Choice 20140601 | $2,648 |
| Aetna POS 20140601 | 235_aetna POS 20140601 | $2,648 |
| Aetna Aco HMO | 4489_aetna Aco HMO 20250801 | $2,693 |
| Aetna Sha Aisd | 4335_aetna Sha Aisd 20250101 | $2,733 |
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All common services at Ascension Seton Smithville (Ascension Seton)