Emergency visit, high (level 4) at Grace Surgical Hospital. CPT 99284.
What Grace Surgical Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$998cash price (self-pay)
$2,376list price
$407–$1,833range 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 | $534 |
| Aetna | Preferred Other Commercial Plan | $556 |
| Baylor Scott And White | Group Bsw Premier/Covenant Preferred All Comm | $646 |
| Baylor Scott And White | Group Bsw Plus All Commercial Plans | $900 |
| Bcbs | Hmo | $1,200 |
| Bcbs | Par Traditional | $1,397 |
| Bcbs | Ers Hmo | $1,727 |
| Bcbs | Ppo | $1,833 |
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