Emergency visit, moderate (level 3) at Holy Cross Hospital - Davis. CPT 99283.
What Holy Cross Hospital - Davis publishes for this service, straight from its standard-charges file, last updated February 11, 2026.
Outpatient / ER
$470cash price (self-pay)
$1,175list price
$57.05–$1,175range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Medicaid | Managed Medicaid | $57.05 |
| UUHP | Managed Medicaid | $57.05 |
| Humana | Managed Medicare | $65.79 |
| Managed Medicare | Managed Medicare | $65.79 |
| Medicare | Medicare | $65.79 |
| Employer Direct Healthcare | Commercial PPO/POS/HMO | $82.57 |
| MotivHealth | Commercial PPO/POS/HMO | $87.27 |
| Select Health | Commercial PPO/POS/HMO | $106 |
| Molina | Commercial PPO/POS/HMO | $139 |
| PEHP | Commercial Summit Exclusive | $164 |
| Centura Employee Plan | Commercial PPO/POS/HMO/EPO | $235 |
| Regence Blue Cross Blue Shield | Commercial PAR | $272 |
| Regence Blue Cross Blue Shield | Commercial PPO | $272 |
| Regence Blue Cross Blue Shield | Commercial Savewell | $272 |
| Regence Blue Cross Blue Shield | Commercial UVU | $272 |
| PEHP | Commercial Capital Network | $502 |
| Aetna | Commercial Peak Performance | $519 |
| UUHP | Commercial Health Plus | $579 |
| UUHP | Commercial Healthy Preferred | $579 |
| PEHP | Commercial Summit | $598 |
| Wise | Commercial PPO | $611 |
| Aetna | Commercial Standard Network | $619 |
| UUHP | Commercial Healthy Premier | $637 |
| Regence Blue Cross Blue Shield | Commercial Blue Option | $652 |
| PEHP | Commercial Advantage | $681 |
| Deseret Mutual Benefit Administrators | Commercial PPO/POS/HMO | $721 |
| Multiplan | Commercial Primary | $810 |
| United Healthcare | Commercial PPO/POS/HMO | $852 |
| Aetna | Commercial Signature | $854 |
| Aetna | Commercial Extended Network | $881 |
Inpatient
$470cash price (self-pay)
$1,175list price
$437–$1,175range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Regence Blue Cross Blue Shield | Commercial Savewell | $437 |
| PEHP | Commercial Capital Network | $502 |
| Molina | Commercial PPO/POS/HMO | $504 |
| Aetna | Commercial Peak Performance | $519 |
| Regence Blue Cross Blue Shield | Commercial UVU | $538 |
| PEHP | Commercial Summit Exclusive | $556 |
| Select Health | Commercial PPO/POS/HMO | $577 |
| PEHP | Commercial Summit | $598 |
| Aetna | Commercial Standard Network | $619 |
| Wise | Commercial PPO | $623 |
| Regence Blue Cross Blue Shield | Commercial PPO | $633 |
| PEHP | Commercial Advantage | $681 |
| Regence Blue Cross Blue Shield | Commercial Blue Option | $705 |
| Regence Blue Cross Blue Shield | Commercial PAR | $705 |
| Deseret Mutual Benefit Administrators | Commercial PPO/POS/HMO | $721 |
| Multiplan | Commercial Primary | $810 |
| Aetna | Commercial Signature | $854 |
| Aetna | Commercial Extended Network | $881 |
| Aetna | Commercial Indemnity | $940 |
| Aetna Rental Networks | Commercial PPO/POS/HMO | $993 |
| EMI Health | Commercial PPO/POS/HMO | $1,022 |
| Multiplan | Commercial Complementary | $1,069 |
| United Healthcare | Commercial Behavioral Health | $1,175 |
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