Emergency visit, moderate (level 3) at Intermountain Health Intermountain Medical Center. CPT 99283.
What Intermountain Health Intermountain Medical Center publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$1,839cash price (self-pay)
$2,452list price
$70.48–$2,207range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Plan of Nevada | Medicaid | $265 |
| SelectHealth | Medicaid | $265 |
| Aetna | Medicare Adv HMO | $265 |
| Healthy U | Medicaid | $265 |
| Molina | Medicaid | $265 |
| TriWest | Veterans Choice | $265 |
| American Health | Medicare Adv UT HMO I-SNP | $276 |
| Health Partners of Nevada | Medicare Advantage | $276 |
| Humana | Medicare Choice PPO | $276 |
| Molina | Medicare Advantage | $276 |
| Molina | Medicare Choice Care HMO | $276 |
| Molina | Medicare Complete Care HMO SNP | $276 |
| Regence BCBS | MedAdvantage PPO | $276 |
| SelectHealth | Medicare Advantage | $276 |
| UHC | Medicare Advantage | $276 |
| SelectHealth | Signature Individual ACA | $282 |
| SelectHealth | Value Individual ACA | $282 |
| Aetna | Medicare Adv PPO | $292 |
| SelectHealth | Med Individual ACA | $308 |
| Donor Connect | Other | $574 |
| Intermountain Caregiver Plan | Share Network | $947 |
| SelectHealth | SelectShare | $947 |
| SelectHealth | SelectValue | $947 |
| SelectHealth | FEHBP | $1,040 |
| Intermountain Caregiver Plan | Med Network | $1,141 |
| SelectHealth | CHP | $1,141 |
| SelectHealth | Commercial | $1,141 |
| SelectHealth | SelectCare | $1,241 |
| Deseret Mutual | All Other | $1,410 |
| Deseret Mutual | Select | $1,410 |
Inpatient
$1,839cash price (self-pay)
$2,452list price
$29.43–$2,207range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $29.43 |
| Health Plan of Nevada | Medicaid | $736 |
| Intermountain Caregiver Plan | Med Network | $1,040 |
| Intermountain Caregiver Plan | Share Network | $1,040 |
| EMI | Commercial | $1,324 |
| Deseret Mutual | All Other | $1,410 |
| Deseret Mutual | Select | $1,410 |
| Regence BCBS | BlueOption | $1,514 |
| Regence BCBS | Cardiac Care | $1,514 |
| AWH Connected | Connected Utah | $1,557 |
| EMI Health | Mint | $1,702 |
| EMI Health | Network Care | $1,702 |
| PEHP | Advantage State | $1,707 |
| Corporation of the President | Workers Comp | $1,717 |
| Regence BCBS | High Performance | $1,717 |
| Regence BCBS | FEHBP | $1,729 |
| PEHP | Advantage Non-State | $1,741 |
| AG Administrators | USU Athletics | $1,766 |
| BYU Athletics | Commercial | $1,766 |
| BYU Risk Management | Workers Comp | $1,766 |
| Campbell Scientific | Commercial | $1,766 |
| CorVel Corporation | Workers Comp | $1,766 |
| Franklin County | Commercial | $1,766 |
| Juniper Systems | Commercial | $1,766 |
| LW Miller | Commercial | $1,766 |
| Injury Care of Nevada | Workers Comp | $1,839 |
| Regence BCBS | Traditional | $1,864 |
| Managed Care Admin | Commercial | $1,913 |
| Aetna | Connected | $1,962 |
| Molina | CHIP | $2,011 |
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All common services at Intermountain Health Intermountain Medical Center