Emergency visit, high (level 4) at Lewisgale Hospital-montgomery. CPT 99284.
What Lewisgale Hospital-montgomery publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$3,135cash price (self-pay)
$3,135list price
$545–$3,919range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | NPR | $545 |
| Virginia Health Network | ULTRA | $1,097 |
| United | OptionsPPO | $1,213 |
| Cigna | HMO | $1,304 |
| Cigna | PPO | $1,304 |
| United | GlobalBenefitPlan | $1,411 |
| Greenvbrier Sporting Club | COMM | $1,881 |
| Multiplan | PHCS | $2,100 |
| Virginia Health Network | COMM | $2,226 |
| Virginia Health Network | WC | $2,226 |
| CorVel | WorkersComp | $2,257 |
| Richfield Nursing Center | COMM | $2,351 |
| Richfield Retirement Community | COMM | $2,351 |
| Community Care Network | COMM | $2,508 |
| Graham-White Manufacturing | COMM | $2,508 |
| OccuNet Workers Comp | WorkersComp | $2,508 |
| One Health Plan | POS | $2,508 |
| One Health Plan | PPO | $2,508 |
| Aetna | SharedSavings | $2,528 |
| Phcs | Comm | $2,665 |
| Patients Choice | COMM | $2,759 |
| 4Most | COMM | $2,822 |
| American Postal Workers Union | COMM | $2,822 |
| Star Transportation | COMM | $2,822 |
| Anthem | HIX | $2,939 |
| Anthem | HMO | $3,264 |
| Anthem | PPO | $3,264 |
| Sentara Optima Health | HMO | $3,348 |
| Sentara Optima Health | POS | $3,348 |
| Sentara Optima Health | PPO | $3,348 |
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