Emergency visit, high (level 4) at Medical City Surgical Hospital Alliance. CPT 99284.
What Medical City Surgical Hospital Alliance publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$3,669cash price (self-pay)
$3,669list price
$77.04–$5,296range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina | CHIP | $320 |
| Molina | MCDSTAR | $320 |
| Molina | STAR+PLUS | $320 |
| Molina | STARKIDS | $320 |
| Amerigroup | CHIP | $363 |
| Amerigroup | MGMCD | $363 |
| Cigna | IFP | $495 |
| Cigna | QHP | $514 |
| Superior Health Plan | MGMCRDualEligible | $546 |
| Superior Health Plan | MGMCRHMO | $546 |
| Cigna Healthspring | MGMCD | $700 |
| United | OptionsPPO | $811 |
| Healthcare Highways | CityofPlano | $1,240 |
| BCBS | Traditional | $1,519 |
| United | NarrowNetworkIndivExchange | $1,545 |
| United | GlobalBenefitPlan | $1,651 |
| Aetna | ASA | $1,853 |
| United | SmallGroup | $1,937 |
| Aetna Coventry First Health | COMM | $2,102 |
| HealthSmart Preferred Care | PPO | $2,752 |
| Multiplan | PHCSPrimaryNetwork | $2,752 |
| United | AllPayerAppendix | $2,931 |
| Multiplan | ComplementaryNetwork | $3,119 |
| BCBS | BlueAdvantageHMO | $3,320 |
| BCBS | MyBlueHealth | $3,320 |
| Healthcare Highways | NarrowNetwork | $3,542 |
| Evry Health | COMM | $3,626 |
| Independent Medical Systems | COMM | $3,669 |
| National Healthcare Solutions | COMM | $3,669 |
| Cigna | LocalPlus | $3,746 |
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All common services at Medical City Surgical Hospital Alliance