Emergency visit, high (level 4) at Mountain West Medical Center. CPT 99284.
What Mountain West Medical Center publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$1,315cash price (self-pay)
$2,191list price
$360–$4,459range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Regence BCBS-All Other Plans | Regence BCBS-All Other Plans | $360 |
| Regence BCBS Mcr Adv | Regence BCBS Mcr Adv | $422 |
| Select Health Mcr Adv | Select Health Mcr Adv | $422 |
| Molina Medicare-All Plans | Molina Medicare-All Plans | $528 |
| U Of Ut-All Plans | U Of Ut-All Plans | $1,424 |
| Wise/Motivhealth-All Plans | Wise/Motivhealth-All Plans | $1,424 |
| Cigna-All Plans | Cigna-All Plans | $1,554 |
| Dmba-All Plans | Dmba-All Plans | $1,578 |
| Pehp-All Plans | Pehp-All Plans | $1,644 |
| Select Health-All Other Plans | Select Health-All Other Plans | $1,644 |
| UHC-All Plans | UHC-All Plans | $1,687 |
| Multiplan Primary Network-All Other Plans | Multiplan Primary Network- | $1,731 |
| Emi-All Plans | Emi-All Plans | $1,863 |
| Humana-All Plans | Humana-All Plans | $1,863 |
| Multiplan Complimentary Network | Multiplan Complimentary Network | $2,016 |
| Aetna -All Plans | Aetna -All Plans | $4,459 |
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