Emergency visit, high (level 4) at St. Luke's Health Memorial San Augustine. CPT 99284.

What St. Luke's Health Memorial San Augustine publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$481cash price (self-pay)

$3,209list price

$391–$5,170range insurers pay

Insurance plan	Negotiated rate
AETNA \| Medicare\|All Plans	$391
HUMANA \| Medicare\|All Plans	$391
Wellpoint \| Medicare\|All Plans	$402
CIGNA HEALTHSPRING \| Medicare\|All Other Plans	$410
CIGNA HEALTHSPRING \| Medicare\|PPO	$414
BCBS \| Medicare\|All Plans	$423
UNITED \| Medicare\|All Plans	$423
SCANHealth \| Medicare\|All Plans	$431
MD Save \| Commercial\|All Plans	$488
United \| Commercial\|Exchange	$578
Wellpoint \| Commercial\|Exchange	$634
United \| Commercial\|All Other Plans	$738
BCBS-TX \| Commercial\|Blue Premier	$753
Aetna \| Commercial\|All Plans	$802
BCBS-TX \| Commercial\|Blue Advantage HMO	$858
BCBS-TX \| Commercial\|HMO	$862
BCBS-TX \| Commercial\|PPO	$936
Angelina County \| Commercial\|All Plans	$1,066
Brookshire Brothers \| Commercial\|All Plans	$1,172
PHCS \| Commercial\|All Plans	$2,182
Humana \| Commercial\|All Plans	$2,246
Multiplan \| Commercial\|All Plans	$2,246
Galaxy \| Commercial\|All Plans	$2,888
SUPERIOR \| Medicaid\|All Other Plans	$2,888
SUPERIOR \| Medicaid\|STARPLUS	$2,888
TCHP \| Medicaid\|All Plans	$2,888
UNITED \| Medicaid\|All Other Plans	$2,888
UNITED \| Medicaid\|CHIP	$2,888
UNITED \| Medicaid\|STAR	$2,888
UNITED \| Medicaid\|STARKIDS	$2,888

$481cash price (self-pay)

$3,209list price

$802–$3,209range insurers pay

Insurance plan	Negotiated rate
Aetna \| Commercial\|All Plans	$802
Humana \| Commercial\|All Plans	$2,246
Multiplan \| Commercial\|All Plans	$2,246
PHCS \| Commercial\|All Plans	$2,567
Galaxy \| Commercial\|All Plans	$2,888
United \| Commercial\|Exchange	$3,209

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