Emergency visit, high (level 4) at Memorial Hermann Southeast Hospital. CPT 99284.
What Memorial Hermann Southeast Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,310cash price (self-pay)
$4,093list 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 | Prem/Select Exchange | $629 |
| Aetna | Exchange | $650 |
| Community Health | Ultra Exchange | $671 |
| 90 Degrees | All Commercial Plans | $796 |
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