Emergency visit, moderate (level 3) at Lake Granbury Medical Center. CPT 99283.
What Lake Granbury Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$544cash price (self-pay)
$3,024list price
$67.29–$2,873range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| NODE Aetna CHIP Medicaid TX | NODE Aetna CHIP Medicaid TX | $226 |
| NODE Cook Childrens Health Plan CHIP Medicaid TX | NODE Cook Childrens | $226 |
| Medicaid | NODE TX Medicaid | $226 |
| NON PAR TX Medicaid | NODE TX Medicaid NON PAR | $226 |
| NODE UHC CHIP/STAR KIDS Medicaid TX | NODE UHC CHIP Medicaid TX | $226 |
| NODE UHC STAR KIDS Medicaid TX | NODE UHC STAR KIDS Medicaid TX | $226 |
| NODE UHC STAR Medicaid TX | NODE UHC STAR Medicaid TX | $226 |
| Healthspring | NODE Cigna Healthspring Medicaid TX | $238 |
| NODE Molina CHIP Medicaid TX | NODE Molina CHIP Medicaid TX | $238 |
| NODE Molina Medicaid TX | NODE Molina STAR Medicaid TX | $238 |
| Amerigroup | NODE Wellpoint CHIP Medicaid TX | $250 |
| NODE Superior CHIP/STAR KIDS/ STAR HEALTH Medicaid TX | NODE Superior | $260 |
| NODE Superior STAR KIDS Medicaid TX | NODE Superior STAR KIDS Medicaid | $260 |
| Superior | NODE Superior STAR Medicaid TX | $260 |
| NODE Superior STAR PLUS Medicaid TX | NODE Superior STAR PLUS Medicaid | $260 |
| NODE Tricare | NODE Tricare | $261 |
| NODE ChampVA | NODE ChampVA | $274 |
| NODE Aetna STAR KIDS Medicaid TX | NODE Aetna STAR KIDS Medicaid TX | $308 |
| NODE Cook Childrens Health Plan STAR KIDS Medicaid TX | NODE Cook Chil | $308 |
| United Healthcare | NODE UHC STAR PLUS Medicaid TX | $701 |
| NODE Molina STAR PLUS Medicaid TX | NODE Molina STAR PLUS Medicaid TX | $736 |
| CHS Group Health Plan BCBST | CHS Group Health Plan BCBST | $762 |
| BCBS TX | BCBS TX Blue ADV | $767 |
| Cigna | Cigna New Business | $768 |
| BCBS TX | BCBS TX HMO | $807 |
| BCBS TX | BCBS TX PPO Trad | $807 |
| Aetna | NODE Aetna STAR Medicaid TX | $814 |
| NODE Cook Childrens Health Plan Medicaid TX | NODE Cook Childrens Heal | $814 |
| Cigna | Cigna ALL | $1,191 |
| Aetna | Aetna Whole Health | $1,376 |
Inpatient
$816cash price (self-pay)
$3,024list price
$333–$2,873range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self Pay | Self Pay | $333 |
| CHS Group Health Plan BCBST | CHS Group Health Plan BCBST | $762 |
| Cigna | Cigna New Business | $768 |
| United Healthcare | UHC APA | $1,286 |
| Aetna | Aetna Whole Health | $1,376 |
| Aetna | Aetna NBD | $1,452 |
| Aetna | Aetna PPO HMO | $1,618 |
| Healthsmart | Healthsmart ACCEL | $1,663 |
| Aetna | Aetna NAB First Health Rental | $1,721 |
| Aetna | Aetna Auto | $2,077 |
| Healthsmart | Healthsmart PPO HPO | $2,117 |
| Santa Fe Hospital Association | Santa Fe Hospital Association | $2,419 |
| Multiplan | Multiplan Complementary | $2,661 |
| Galaxy Health | Galaxy Health PPO | $2,873 |
| MedCorp Southwest | MedCorp Southwest | $2,873 |
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