Emergency visit, high (level 4) at Baylor Scott & White Mclane Children's Medical Center. CPT 99284.
What Baylor Scott & White Mclane Children's Medical Center publishes for this service, straight from its standard-charges file, last updated June 13, 2026.
Outpatient / ER
$1,602cash price (self-pay)
$2,669list price
$398–$4,020range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | $398 |
| Superior Health Plan | Medicaid | $400 |
| CORVEL | Worker's Compensation | $407 |
| TriWest | Community Care Network | $419 |
| United Healthcare | Medicaid/CHIP | $428 |
| American Health Plan | Medicare Advantage | $440 |
| Blue Cross Blue Shield | Medicare Advantage | $440 |
| ProCare Advantage | Medicare Advantage | $440 |
| United Healthcare | Medicare Advantage | $469 |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $503 |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $526 |
| Prime Health Services | Worker's Compensation | $529 |
| CareWorks fka Rockport | Worker's Compensation | $627 |
| Sedgwick | Preferred Network | $627 |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $692 |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premi | $1,100 |
| Employers Health Network | BSWQA Direct/EHN Rental | $1,255 |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier | $1,295 |
| University of Mary Hardin-Baylor | Commercial | $1,301 |
| QuikTrip | Employee Benefit Plan | $1,468 |
| Employers Health Network | EHN Network | $1,468 |
| MidCoast | Commercial | $1,468 |
| Independent Medical System | Commercial PPO | $1,602 |
| Curative | Commercial | $1,735 |
| First Health | PPO | $1,869 |
| Humana | Commercial PPO | $1,869 |
| HealthSmart | Accel Network | $2,002 |
| HealthSmart | Preferred Network | $2,002 |
| Private Health Care System | PHCS Network | $2,002 |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My Blue | $2,700 |
Inpatient
$1,602cash price (self-pay)
$2,669list price
$1,468–$1,869range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| QuikTrip | Employee Benefit Plan | $1,468 |
| MidCoast | Commercial | $1,468 |
| Independent Medical System | Commercial PPO | $1,602 |
| Curative | Commercial | $1,735 |
| First Health | PPO | $1,869 |
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All common services at Baylor Scott & White Mclane Children's Medical Center