Emergency visit, high (level 4) at Texoma Medical Center. CPT 99284.
What Texoma Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$2,305cash price (self-pay)
$3,595list price
$97.38–$3,334range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior | Medicaid | $97.38 |
| Molina | Medicaid | $100 |
| Tchp Star | Medicaid | $100 |
| UHC Star Plus | Medicaid | $200 |
| Wellpt Amgrp Str Pls | Medicaid | $200 |
| Superior Hlth Str Pls | Medicaid | $205 |
| Molina Star Plus | Medicaid | $211 |
| Wellpoint Starkids | Medicaid | $222 |
| Amerigroup | Medicaid | $336 |
| UHC Star | Medicaid | $336 |
| Superior Star | Medicaid | $343 |
| Oklahoma | Medicaid | $353 |
| Tchp | Medicaid | $353 |
| Healthchoice | Managed_care | $532 |
| Aetna | Managed_care | $917 |
| Coventry_healthfirst | Managed_care | $935 |
| Cigna | HMO | $1,643 |
| Multiplan | Managed_care | $1,916 |
| Humana | Managed_care | $2,096 |
| Blue_cross_blue_shield_of_tx | Qhp | $2,460 |
| Healthsmart | Managed_care | $2,696 |
| Blue_cross_blue_shield_of_tx | HMO | $2,940 |
| Blue_cross_blue_shield_of_tx | PPO | $2,960 |
| UHC Exchange | Qhp | $3,114 |
| United_healthcare | Managed_care | $3,334 |
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