Emergency visit, highest (level 5) at Intermountain Health Fillmore Community Hospital. CPT 99285.
What Intermountain Health Fillmore Community Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$2,800cash price (self-pay)
$3,734list price
$173–$3,584range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $173 |
| Aetna | Medicare Adv PPO | $173 |
| American Health | Medicare Adv UT HMO I-SNP | $173 |
| Health Partners of Nevada | Medicare Advantage | $173 |
| Health Plan of Nevada | Medicaid | $173 |
| Humana | Medicare Choice PPO | $173 |
| Molina | Medicaid | $173 |
| Molina | Medicare Complete Care HMO SNP | $173 |
| Regence BCBS | MedAdvantage | $173 |
| Regence BCBS | MedAdvantage PPO | $173 |
| SelectHealth | Medicaid | $173 |
| SelectHealth | Medicare Advantage | $173 |
| UHC | Medicare Advantage | $173 |
| Healthy U | Medicaid | $1,718 |
| Injury Care of Nevada | Workers Comp | $2,800 |
| BYU Risk Management | Workers Comp | $3,174 |
| CorVel Corporation | Workers Comp | $3,174 |
| Corporation of the President | Workers Comp | $3,174 |
| AG Administrators | USU Athletics | $3,547 |
| Aetna | Standard | $3,547 |
| BYU Athletics | Commercial | $3,547 |
| Campbell Scientific | Commercial | $3,547 |
| Cigna | HMO | $3,547 |
| Cigna | Open Access Flex | $3,547 |
| Cigna | PPO/EPO | $3,547 |
| Deseret Mutual | All Other | $3,547 |
| Deseret Mutual | Select | $3,547 |
| EMI Health | Mint | $3,547 |
| EMI Health | Network Care | $3,547 |
| EMI | Commercial | $3,547 |
Inpatient
$2,800cash price (self-pay)
$3,734list price
$2,800–$3,547range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Injury Care of Nevada | Workers Comp | $2,800 |
| BYU Risk Management | Workers Comp | $3,174 |
| CorVel Corporation | Workers Comp | $3,174 |
| Corporation of the President | Workers Comp | $3,174 |
| Health Plan of Nevada | Medicaid | $3,323 |
| Healthy U | Medicaid | $3,323 |
| Molina | Medicaid | $3,323 |
| AG Administrators | USU Athletics | $3,547 |
| AWH Connected | Connected Utah | $3,547 |
| Aetna | Connected | $3,547 |
| Aetna | Extended | $3,547 |
| Aetna | Standard | $3,547 |
| BYU Athletics | Commercial | $3,547 |
| Campbell Scientific | Commercial | $3,547 |
| Cigna | HMO | $3,547 |
| Cigna | Open Access Flex | $3,547 |
| Cigna | PPO/EPO | $3,547 |
| Deseret Mutual | All Other | $3,547 |
| Deseret Mutual | Select | $3,547 |
| EMI Health | Mint | $3,547 |
| EMI Health | Network Care | $3,547 |
| EMI | Commercial | $3,547 |
| Franklin County | Commercial | $3,547 |
| Global Excel | Commercial | $3,547 |
| Health Utah | Commercial | $3,547 |
| Hygeia Corporation | Commercial | $3,547 |
| Intermountain Caregiver Plan | Med Network | $3,547 |
| Juniper Systems | Commercial | $3,547 |
| LW Miller | Commercial | $3,547 |
| Managed Care Admin | Commercial | $3,547 |
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All common services at Intermountain Health Fillmore Community Hospital