Emergency visit, high (level 4) at Intermountain Health Logan Regional Hospital. CPT 99284.
What Intermountain Health Logan Regional Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$1,867cash price (self-pay)
$2,489list price
$119–$2,462range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $119 |
| Aetna | Medicare Adv PPO | $119 |
| American Health | Medicare Adv UT HMO I-SNP | $119 |
| Health Partners of Nevada | Medicare Advantage | $119 |
| Healthy U | Medicaid | $119 |
| Humana | Medicare Choice PPO | $119 |
| Molina | Medicaid | $119 |
| Molina | Medicare Advantage | $119 |
| Molina | Medicare Choice Care HMO | $119 |
| Molina | Medicare Complete Care HMO SNP | $119 |
| Regence BCBS | MedAdvantage PPO | $119 |
| SelectHealth | Medicare Advantage | $119 |
| Southwest Behavioral Health | Behavioral Health | $119 |
| UHC | Medicare Advantage | $119 |
| Health Plan of Nevada | Medicaid | $270 |
| SelectHealth | Medicaid | $270 |
| Donor Connect | Other | $662 |
| EMI | Commercial | $1,727 |
| Deseret Mutual | All Other | $1,732 |
| Deseret Mutual | Select | $1,732 |
| Campbell Scientific | Commercial | $1,742 |
| Franklin County | Commercial | $1,742 |
| Intermountain Caregiver Plan | Med Network | $1,759 |
| Intermountain Caregiver Plan | Share Network | $1,759 |
| CorVel Corporation | Workers Comp | $1,867 |
| Corporation of the President | Workers Comp | $1,867 |
| AWH Connected | Connected Utah | $1,937 |
| EMI Health | Mint | $1,999 |
| EMI Health | Network Care | $1,999 |
| AG Administrators | USU Athletics | $2,116 |
Inpatient
$1,867cash price (self-pay)
$2,489list price
$52.27–$2,365range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $52.27 |
| Health Plan of Nevada | Medicaid | $747 |
| Intermountain Caregiver Plan | Med Network | $1,055 |
| Intermountain Caregiver Plan | Share Network | $1,055 |
| Campbell Scientific | Commercial | $1,742 |
| Franklin County | Commercial | $1,742 |
| Juniper Systems | Commercial | $1,742 |
| LW Miller | Commercial | $1,742 |
| CorVel Corporation | Workers Comp | $1,867 |
| Corporation of the President | Workers Comp | $1,867 |
| Injury Care of Nevada | Workers Comp | $1,867 |
| AG Administrators | USU Athletics | $2,116 |
| Altius MHNet Behavioral Health | Behavioral Health | $2,116 |
| BYU Athletics | Commercial | $2,116 |
| BYU Risk Management | Workers Comp | $2,116 |
| Cigna | Open Access Flex | $2,116 |
| Global Excel | Commercial | $2,116 |
| MedCare International | Commercial | $2,116 |
| AWH Connected | Connected Utah | $2,123 |
| Deseret Mutual | All Other | $2,123 |
| Deseret Mutual | Select | $2,123 |
| EMI Health | Mint | $2,123 |
| EMI Health | Network Care | $2,123 |
| EMI | Commercial | $2,123 |
| Managed Care Admin | Commercial | $2,123 |
| PEHP | Advantage Non-State | $2,123 |
| PEHP | Advantage State | $2,123 |
| PEHP | Capital Care | $2,123 |
| Aetna | Connected | $2,365 |
| Aetna | Extended | $2,365 |
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All common services at Intermountain Health Logan Regional Hospital