Emergency visit, moderate (level 3) at Intermountain Health Spanish Fork Hospital. CPT 99283.
What Intermountain Health Spanish Fork Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$1,383cash price (self-pay)
$1,844list price
$70.48–$1,660range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TriWest | Veterans Choice | $265 |
| Health Plan of Nevada | Medicaid | $276 |
| SelectHealth | Medicaid | $276 |
| Aetna | Medicare Adv HMO | $276 |
| Health Partners of Nevada | Medicare Advantage | $276 |
| Healthy U | Medicaid | $276 |
| SelectHealth | Medicare Advantage | $276 |
| UHC | Medicare Advantage | $276 |
| American Health | Medicare Adv UT HMO I-SNP | $287 |
| Regence BCBS | MedAdvantage PPO | $287 |
| SelectHealth | Signature Individual ACA | $288 |
| SelectHealth | Value Individual ACA | $288 |
| Humana | Medicare Choice PPO | $290 |
| Aetna | Medicare Adv PPO | $304 |
| Molina | Medicare Advantage | $304 |
| Molina | Medicare Complete Care HMO SNP | $304 |
| SelectHealth | Med Individual ACA | $316 |
| Donor Connect | Other | $498 |
| Intermountain Caregiver Plan | Share Network | $947 |
| SelectHealth | SelectShare | $947 |
| SelectHealth | SelectValue | $947 |
| SelectHealth | FEHBP | $1,004 |
| Deseret Mutual | Commercial | $1,060 |
| Deseret Mutual | Connected Utah | $1,060 |
| Intermountain Caregiver Plan | CHP | $1,141 |
| Intermountain Caregiver Plan | Med Network | $1,141 |
| SelectHealth | SelectMed/CHIP | $1,141 |
| Cigna | Open Access Flex | $1,162 |
| AWH Connected | Connected Utah | $1,189 |
| SelectHealth | SelectCare | $1,198 |
Inpatient
$1,383cash price (self-pay)
$1,844list price
$120–$1,660range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Donor Connect | Other | $120 |
| SelectHealth | Med Individual ACA | $549 |
| Health Plan of Nevada | Medicaid | $553 |
| Intermountain Caregiver Plan | Share Network | $782 |
| SelectHealth | FEHBP | $782 |
| Intermountain Caregiver Plan | CHP | $889 |
| Intermountain Caregiver Plan | Med Network | $889 |
| EMI | Commercial | $996 |
| Deseret Mutual | Commercial | $1,060 |
| Deseret Mutual | Connected Utah | $1,060 |
| Regence BCBS | BlueOption | $1,139 |
| Cigna | Open Access Flex | $1,162 |
| AWH Connected | Connected Utah | $1,171 |
| EMI Health | Mint | $1,280 |
| EMI Health | Network Care | $1,280 |
| PEHP | Advantage State | $1,283 |
| BYU Risk Management | Workers Comp | $1,291 |
| Corporation of the President | Workers Comp | $1,291 |
| Regence BCBS | High Performance | $1,291 |
| Regence BCBS | FEHBP | $1,300 |
| PEHP | Advantage Non-State | $1,309 |
| BYU Athletics | Commercial | $1,328 |
| Campbell Scientific | Commercial | $1,328 |
| CorVel Corporation | Workers Comp | $1,328 |
| Franklin County | Commercial | $1,328 |
| Juniper Systems | Commercial | $1,328 |
| LW Miller | Commercial | $1,328 |
| Injury Care of Nevada | Workers Comp | $1,383 |
| Regence BCBS | Traditional | $1,401 |
| Managed Care Admin | Commercial | $1,438 |
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All common services at Intermountain Health Spanish Fork Hospital