Emergency visit, high (level 4) at Medical Center Of Southeast Texas. CPT 99284.
What Medical Center Of Southeast Texas publishes for this service, straight from its standard-charges file, last updated September 2, 2026.
Outpatient / ER
$412cash price (self-pay)
$1,981list price
$50.00–$2,640range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Health Choice CHIP | Community Health Choice CHIP | $114 |
| Molina Medicaid | Molina Medicaid | $165 |
| Community Health Choice STAR UHRIP | Community Health Choice STAR UHRI | $286 |
| Molina Healthcare STAR UHRIP | Molina Healthcare STAR UHRIP | $300 |
| Humana Medicare Advantage | Humana Medicare Advantage | $398 |
| BCBS of Texas Medicare Adv HMO | BCBS of Texas Medicare Adv HMO | $412 |
| Healthspring Medicare Advantage | Healthspring Medicare Advantage | $412 |
| finthrive | Medicare | $412 |
| Provider Partners Health Plan | Provider Partners Health Plan | $412 |
| SelectCare | SelectCare | $412 |
| Superior HealthPlan Medicare Advantage | Superior HealthPlan Medicare | $412 |
| TIHP (Texas Independence Health Plan) | TIHP (Texas Independence Healt | $412 |
| United Healthcare Medicare Advantage | United Healthcare Medicare Adva | $412 |
| Wellpoint Amerigroup Med Advantage | Wellpoint Amerigroup Med Advantag | $412 |
| Texas Medical Management Partners | Texas Medical Management Partners | $419 |
| Triwest VA | Triwest VA | $419 |
| Molina Medicare Advantage | Molina Medicare Advantage | $421 |
| Molina Healthcare STAR PLUS UHRIP | Molina Healthcare STAR PLUS UHRIP | $425 |
| WellCare | WellCare | $433 |
| League Medical Concepts | League Medical Concepts | $454 |
| WellPath | WellPath | $461 |
| Community Health Choice HIX | Community Health Choice HIX | $503 |
| United Healthcare Exchange HIX | United Healthcare Exchange HIX | $524 |
| Molina HIX | Molina HIX | $566 |
| ELAP Services | ELAP Services | $813 |
| BCBS of Texas Traditional | BCBS of Texas Traditional | $818 |
| Cigna Commercial | Cigna Commercial | $866 |
| Aetna HMO | Aetna HMO | $1,149 |
| Magellan Behavioral Health | Magellan Behavioral Health | $1,189 |
| First Health | First Health | $1,387 |
Inpatient
—cash price (self-pay)
$1,981list price
$818–$1,981range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS of Texas Traditional | BCBS of Texas Traditional | $818 |
| Magellan Behavioral Health | Magellan Behavioral Health | $1,189 |
| Galaxy Health Network | Galaxy Health Network | $1,387 |
| Texas Municipal League | Texas Municipal League | $1,387 |
| Multiplan | Multiplan | $1,585 |
| United Behavioral Health | United Behavioral Health | $1,981 |
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