Emergency visit, high (level 4) at Dell Children's Medical Center (Ascension Seton). CPT 99284.
What Dell Children's Medical Center (Ascension Seton) publishes for this service, straight from its standard-charges file, last updated June 17, 2024.
Outpatient / ER
—cash price (self-pay)
—list price
$117–$3,194range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Champva | 1135_champva Rest_tx 20180301 | $117 |
| Champva | 1136_champva Austin 20180301 | $118 |
| Superior Star | 2298_chirp Superior Star (Chi,Dcn) 20220901 | $200 |
| Tricare | 1229_tricare Cah Outpatient 20170101 | $316 |
| Tricare | 475_tricare Outpatient 20161001 | $316 |
| Superior Ambetter | 2498_superior Ambetter (Chi,Dcn) 20220901 | $348 |
| BCBS Bav Exchange | 2564_blue Cross Blue Shield Bav Exchange 20230101 | $539 |
| Humana HMO | 2668_humana HMO 20230701 | $1,136 |
| Whole Foods | 2411_whole Foods 20221001 | $1,140 |
| Aetna HMO Exchange | 1377_aetna HMO Exchange 20200101 | $1,185 |
| Aetna | 235_aetna POS 20140601 | $1,325 |
| Aetna Choice | 236_aetna Elect Choice 20140601 | $1,325 |
| Aetna Sha Aisd | 2694_aetna Sha Aisd 20230701 | $1,340 |
| Oscar Health Exchange | 2497_oscar Health Plan 20230101 | $1,341 |
| Employers Health Network | 2409_employers Health Network 20221001 | $1,344 |
| Aetna Aco HMO | 2692_aetna Aco HMO 20230701 | $1,374 |
| Aetna Multi-Tier Whole Health Sha | 2693_aetna Multi-Tier Whole Health | $1,508 |
| UHC Standard Nexus Aco | 2576_united Healthcare Standard Nexus Aco (Au | $1,605 |
| Aetna HMO | 2691_aetna HMO 20230701 | $1,676 |
| UHC | 2573_united Healthcare (Aus,Hay,Nw,Sw, Bas) 20230101 | $1,922 |
| BCBS HMO Essentials | 2562_blue Cross Blue Shield HMO Essentials 20230 | $2,007 |
| BCBS PPO | 2560_blue Cross Blue Shield PPO 20230101 | $2,224 |
| Humana PPO | 2673_humana PPO 20230701 | $3,194 |
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All common services at Dell Children's Medical Center (Ascension Seton)