Emergency visit, high (level 4) at Fairfield Hospital District. CPT 99284.
What Fairfield Hospital District publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$884cash price (self-pay)
$1,263list price
$131–$2,800range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Community Medicaid | Medicaid | $131 |
| BCBS Blue Advantage HMO | HMO | $340 |
| Medicare Advantage Plans | Medicare | $417 |
| Medicare | Medicare | $417 |
| Aetna Commercial | PPO | $500 |
| United Healthcare Commercial | PPO | $521 |
| 90 Degrees Benefits | PPO | $626 |
| Curative | PPO | $632 |
| BCBS Blue Essentials | HMO | $2,100 |
| BCBS Blue Traditional/PPO/POS | PPO | $2,800 |
Inpatient
$884cash price (self-pay)
$1,263list price
$632–$632range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Curative | PPO | $632 |
| BCBS Blue Traditional/PPO/POS | PPO | $632 |
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