Emergency visit, high (level 4) at Memorial Hermann Imaging Center (Upper Kirby). CPT 99284.
What Memorial Hermann Imaging Center (Upper Kirby) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,362cash price (self-pay)
$4,257list price
$419–$796range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $419 |
| Community Health | Medicare Managed Care Plan | $461 |
| Procare Advantage | Medicare Managed Care Plan | $482 |
| Community Health | Premier/Select Exchange | $629 |
| Aetna | Exchange | $650 |
| Community Health | Ultra Exchange | $671 |
| 90 Degrees | All Commercial Plans | $796 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Memorial Hermann Imaging Center (Upper Kirby)