Emergency visit, high (level 4) at St. Luke's Health - Brazosport Hospital. CPT 99284.
What St. Luke's Health - Brazosport Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$1,269cash price (self-pay)
$3,627list price
$175–$5,687range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellpoint | Medicaid|All Other Plans | $175 |
| TCHP | Medicaid|All Other Plans | $218 |
| UNITED | Medicaid|All Other Plans | $218 |
| BCBS | Medicaid|All Plans | $229 |
| SUPERIOR | Medicaid|All Plans | $229 |
| Wellpoint | Medicaid|STAR | $235 |
| TCHP | Medicaid|STAR | $292 |
| UNITED | Medicaid|STAR | $292 |
| BCBS | Medicare|All Plans | $427 |
| CIGNA-HEALTHSPRING | Medicare|All Plans | $427 |
| HUMANA | Medicare|All Plans | $427 |
| KELSEY | Medicare|All Plans | $427 |
| UNITED | Medicare|All Plans | $427 |
| SELECTCARE | Medicare|All Plans | $439 |
| WellcareTP | Medicare|All Plans | $439 |
| Community Health Choice | Commercial|Exchange | $448 |
| Devoted | Medicare|All Plans | $456 |
| SCANHealth | Medicare|All Plans | $456 |
| Aetna | Medicare|All Plans | $544 |
| Bright Health | Commercial|All Plans | $608 |
| Ambetter | Commercial|All Plans | $618 |
| Wellpoint | Commercial|Exchange | $640 |
| Aetna | Commercial|Exchange | $657 |
| United | Commercial|Exchange | $661 |
| UNITED | Medicaid|STARPLUS | $666 |
| BCBS-TX | Commercial|Blue Options | $704 |
| BCBS-TX | Commercial|Traditional | $782 |
| BCBS-TX | Commercial|PPO-POS | $830 |
| BCBS-TX | Commercial|HMO | $879 |
| Humana | Commercial|All Plans | $922 |
Inpatient
$1,269cash price (self-pay)
$3,627list price
$1,814–$1,814range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health First | Commercial|All Plans | $1,814 |
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All common services at St. Luke's Health - Brazosport Hospital