Emergency visit, high (level 4) at Medical City Mental Health And Wellness Center - Alliance. CPT 99284.
What Medical City Mental Health And Wellness Center - Alliance publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$1,386–$3,786range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | BlueAdvantageHMO | $1,386 |
| BCBS | MyBlueHealth | $1,386 |
| BCBS | BlueEssentials | $1,555 |
| BCBS | BlueEssentialsAccess | $1,555 |
| BCBS | Eposoa | $1,555 |
| BCBS | PPO | $1,555 |
| Aetna | NewBusiness | $2,995 |
| Aetna | COMM | $3,200 |
| Aetna | Meritain | $3,200 |
| Aetna | OON | $3,786 |
Inpatient
—cash price (self-pay)
—list price
$1,386–$1,555range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | BlueAdvantageHMO | $1,386 |
| BCBS | MyBlueHealth | $1,386 |
| BCBS | BlueEssentials | $1,555 |
| BCBS | BlueEssentialsAccess | $1,555 |
| BCBS | Eposoa | $1,555 |
| BCBS | PPO | $1,555 |
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All common services at Medical City Mental Health And Wellness Center - Alliance