Emergency visit, high (level 4) at St. Luke's Health - The Woodlands Hospital. CPT 99284.
What St. Luke's Health - The Woodlands Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$1,372cash price (self-pay)
$3,920list price
$307–$5,609range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Renaissance | Commercial|All Plans | $307 |
| Montgomery Hospital District | Commercial|All Plans | $392 |
| BCBS-TX | Commercial|MyBlue Health Exchange | $514 |
| KelseyCare | Commercial|Exchange | $576 |
| BCBS-TX | Commercial|Exchange | $595 |
| Bright Health | Commercial|All Plans | $608 |
| Cigna | Commercial|All Other Plans | $640 |
| Community Health Choice | Commercial|Exchange | $640 |
| Superior Health Plan | Commercial|All Plans | $640 |
| Wellpoint | Commercial|Exchange | $640 |
| Aetna | Commercial|Exchange | $657 |
| BCBS-TX | Commercial|Blue Premier | $746 |
| BCBS-TX | Commercial|HMO | $985 |
| BCBS-TX | Commercial|PPO | $1,119 |
| KelseyCare | Commercial|All Other Plans | $1,240 |
| United | Commercial|Exchange | $1,333 |
| NXHealth | Commercial|All Plans | $1,386 |
| United | Commercial|Optum | $1,842 |
| Cigna | Commercial|Surefit | $1,862 |
| United | Commercial|Charter | $1,968 |
| Cigna | Commercial|HMO | $2,052 |
| Humana | Commercial|HMO | $2,160 |
| Humana | Commercial|PPO | $2,160 |
| United | Commercial|HMO | $2,186 |
| United | Commercial|PPO | $2,186 |
| Cigna Lifesource | Commercial|Transplant | $2,352 |
| Coventry | Commercial|PPO | $2,548 |
| First Health | Commercial|All Plans | $2,548 |
| Humana | Commercial|Transplant | $2,548 |
| Aetna | Commercial|PPO | $2,666 |
Inpatient
$1,372cash price (self-pay)
$3,920list price
$1,686–$3,920range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TCHPCHIP | Medicaid|HMO | $1,686 |
| CHC | Medicaid|CHIP | $2,156 |
| CHC | Medicaid|HMO | $2,156 |
| TEXASTRUECHOICE | Medicaid|CHIP | $2,156 |
| Coventry | Commercial|PPO | $2,548 |
| First Health | Commercial|All Plans | $2,548 |
| Humana | Commercial|Transplant | $2,548 |
| Cigna | Commercial|Transplant | $2,744 |
| Healthsmart | Commercial|PPO | $2,744 |
| Interlink | Commercial|Transplant | $2,744 |
| MultiPlan | Commercial|All Plans | $2,940 |
| USA Health Network | Commercial|All Plans | $3,332 |
| MHealth Network | Commercial|PPO | $3,920 |
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All common services at St. Luke's Health - The Woodlands Hospital