Emergency visit, highest (level 5) at Intermountain Health LDS Hospital. CPT 99285.
What Intermountain Health LDS Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3,111cash price (self-pay)
$4,149list price
$173–$5,757range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Southwest Behavioral Health | Behavioral Health | $585 |
| TriWest | Veterans Choice | $588 |
| Aetna | Medicare Adv HMO | $602 |
| American Health | Medicare Adv UT HMO I-SNP | $602 |
| Health Partners of Nevada | Medicare Advantage | $602 |
| SelectHealth | Medicare Advantage | $602 |
| UHC | Medicare Advantage | $602 |
| Health Plan of Nevada | Medicaid | $602 |
| SelectHealth | Medicaid | $602 |
| Healthy U | Medicaid | $602 |
| Molina | Medicaid | $602 |
| Regence BCBS | MedAdvantage PPO | $627 |
| SelectHealth | Signature Individual ACA | $628 |
| SelectHealth | Value Individual ACA | $628 |
| Humana | Medicare Choice PPO | $633 |
| Aetna | Medicare Adv PPO | $663 |
| Molina | Medicare Advantage | $663 |
| Molina | Medicare Choice Care HMO | $663 |
| Molina | Medicare Complete Care HMO SNP | $663 |
| SelectHealth | Med Individual ACA | $701 |
| Cigna | Open Access Flex | $2,614 |
| AWH Connected | Connected Utah | $2,676 |
| AG Administrators | USU Athletics | $2,987 |
| BYU Athletics | Commercial | $2,987 |
| Campbell Scientific | Commercial | $2,987 |
| CorVel Corporation | Workers Comp | $2,987 |
| BYU Risk Management | Workers Comp | $3,028 |
| Corporation of the President | Workers Comp | $3,028 |
| Aetna | Connected | $3,360 |
| Aetna | Extended | $3,526 |
Inpatient
$3,111cash price (self-pay)
$4,149list price
$53.93–$3,734range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $53.93 |
| Health Plan of Nevada | Medicaid | $1,245 |
| Intermountain Caregiver Plan | Share Network | $1,759 |
| Intermountain Caregiver Plan | Med Network | $2,000 |
| EMI | Commercial | $2,240 |
| Deseret Mutual | All Other | $2,385 |
| Deseret Mutual | Select | $2,406 |
| Regence BCBS | BlueOption | $2,562 |
| Cigna | Open Access Flex | $2,614 |
| AWH Connected | Connected Utah | $2,634 |
| EMI Health | Mint | $2,879 |
| EMI Health | Network Care | $2,879 |
| PEHP | Advantage State | $2,887 |
| BYU Risk Management | Workers Comp | $2,904 |
| Corporation of the President | Workers Comp | $2,904 |
| Regence BCBS | High Performance | $2,904 |
| Regence BCBS | FEHBP | $2,925 |
| PEHP | Advantage Non-State | $2,945 |
| AG Administrators | USU Athletics | $2,987 |
| BYU Athletics | Commercial | $2,987 |
| Campbell Scientific | Commercial | $2,987 |
| CorVel Corporation | Workers Comp | $2,987 |
| Franklin County | Commercial | $2,987 |
| Juniper Systems | Commercial | $2,987 |
| LW Miller | Commercial | $2,987 |
| Managed Care Admin | Commercial | $2,987 |
| Injury Care of Nevada | Workers Comp | $3,111 |
| Regence BCBS | Traditional | $3,153 |
| Aetna | Connected | $3,319 |
| Molina | CHIP | $3,402 |
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