Emergency visit, high (level 4) at Methodist Stone Oak Rehabilitation Hospital. CPT 99284.
What Methodist Stone Oak Rehabilitation Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$3,641cash price (self-pay)
$3,650list price
$300–$4,681range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Healthcare | CHIP | $320 |
| Molina Healthcare | MCDSTAR | $320 |
| Molina Healthcare | STAR+PLUS | $320 |
| Molina Healthcare | STARKIDS | $320 |
| Amerigroup | CHIP | $363 |
| Amerigroup | MCD | $363 |
| Amerigroup | CHIPBH | $511 |
| Amerigroup | MCDBH | $511 |
| United | OptionsPPO | $916 |
| BCBS | Trad | $1,077 |
| United | SmallGroup | $1,249 |
| TX Healthcare Foundation | PPO | $1,825 |
| HealthSmart Preferred Care | Accel | $2,007 |
| BCBS | MyBlueHealth | $2,060 |
| United | Charter | $2,068 |
| United | NexusACO | $2,068 |
| Focus Health Solutions | COMM | $2,347 |
| Healthcare Highways | NarrowNetwork | $2,347 |
| BCBS | BlueAdvantage | $2,420 |
| Valenz | NXNetwork | $2,441 |
| United | AllPayerAppendix | $2,444 |
| Multiplan | PHCSPrimaryNetwork | $2,737 |
| TriWest Health Alliance | TRICARE | $2,737 |
| Aetna | NarrowNetwork | $2,841 |
| DirectCare America | PPO | $2,920 |
| Evry Health | Broad | $2,995 |
| Multiplan | ComplementaryNetwork | $3,102 |
| BCBS | BlueEssentials | $3,200 |
| BCBS | BlueEssentialsAccess | $3,200 |
| Aetna | NewBusinessRates | $3,381 |
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All common services at Methodist Stone Oak Rehabilitation Hospital