Emergency visit, high (level 4) at Covenant Hospital Plainview. CPT 99284.
What Covenant Hospital Plainview publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$0.42cash price (self-pay)
$1,086list price
$407–$1,164range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcbs | Vapc3 Government | $407 |
| Aetna | Medicare Managed Care Plan | $419 |
| Superior | Wellcare Medicare Managed Care Plan | $440 |
| Unitedhealthcare | Medicare Managed Care Plan | $442 |
| Baylor Scott And White | Individual Bsw Premier Exchange | $724 |
| Bcbs | Hmo | $742 |
| Bcbs | Ers Hmo | $820 |
| Baylor Scott And White | Group Bsw Premier/Covenant Preferred All Comm | $875 |
| Baylor Scott And White | Group Bsw Plus All Commercial Plans | $900 |
| Bcbs | Par Traditional | $1,020 |
| Bcbs | Ppo | $1,164 |
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